Provider Demographics
NPI:1457841983
Name:BUCK, REGAN JAMES (DC)
Entity Type:Individual
Prefix:
First Name:REGAN
Middle Name:JAMES
Last Name:BUCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5842 FAYETTEVILLE RD STE 111
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6294
Mailing Address - Country:US
Mailing Address - Phone:919-237-3008
Mailing Address - Fax:
Practice Address - Street 1:5842 FAYETTEVILLE RD STE 111
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6294
Practice Address - Country:US
Practice Address - Phone:919-237-3008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor