Provider Demographics
NPI:1407922859
Name:BUCK, RICHARD F (CHIROPRACTOR)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:F
Last Name:BUCK
Suffix:
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5606 SECOR RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-1935
Mailing Address - Country:US
Mailing Address - Phone:419-474-1002
Mailing Address - Fax:
Practice Address - Street 1:5606 SECOR RD
Practice Address - Street 2:SUITE A
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-1935
Practice Address - Country:US
Practice Address - Phone:419-474-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC 1472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341749240OtherAETNA
OH137712OtherANTHEM
OH341749240OtherMEDICAL MUTUAL
OH0746483Medicaid
OH10169OtherPARAMOUNT
OH137712OtherANTHEM