Individual
DAVID P BUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4940 COTTONVILLE RD, JAMESTOWN, OH 45335-1522
(937) 675-6830
(937) 675-6835
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3100
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35080389
OH
207QS0010X
Sports Medicine (Family Medicine) Physician
35080389
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000666648
ANTHEM
OH
01
—
000000699778
ANTHEM
OH
05
—
2436911
—
OH
05
—
3810017879
—
WV
01
—
H203790
MEDICARE
OH
01
—
P00954615
RRMCR
OH
Enumeration date
02/13/2006
Last updated
03/10/2021
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