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Individual

STEPHEN R BUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
502 MARQUETTE ST, VALPARAISO, IN 46383-2509
(219) 464-8223
(219) 531-2356
Mailing address
502 MARQUETTE ST, VALPARAISO, IN 46383-2509
(219) 464-8223
(219) 531-2356

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001697A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000083382
BCBS - IN
IN
01
000000306486
ANTHEM BC/BS
IN
05
100207680
IN
Enumeration date
08/23/2006
Last updated
05/23/2008
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