Organization
DODGE CITY MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ANTHONY BUCCO JR. MD, PHD (PRESIDENT)
(256) 287-2345
Entity
Organization
Contact information
Practice address
561 AL HIGHWAY 69 S, SUITE B, HANCEVILLE, AL 35077-3403
(256) 287-2345
Mailing address
PO BOX 1208, CULLMAN, AL 35056-1208
(256) 287-2345
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
MD27216
AL
Other
Enumeration date
03/30/2007
Last updated
12/15/2008
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