Provider Demographics
NPI:1609846427
Name:BUK, ALEXANDRA N (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:N
Last Name:BUK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 N RODNEY PARHAM RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2458
Mailing Address - Country:US
Mailing Address - Phone:501-534-8888
Mailing Address - Fax:501-534-8891
Practice Address - Street 1:4200 N RODNEY PARHAM RD STE 100
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-2458
Practice Address - Country:US
Practice Address - Phone:501-534-8888
Practice Address - Fax:501-534-8891
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR153213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
480021983OtherRR MEDICARE
AR5K080OtherBLUE CROSS SHIELD
AR129571717Medicaid
AR5K080OtherBLUE ADVANTAGE
AR5K080OtherHEALTH ADVANTAGE
AR5K080OtherFIRST SOURCE PPO
AR5K080OtherBCBS FEP
AR5K080OtherBCBS FEP
AR5K080OtherFIRST SOURCE PPO
AR129571717Medicaid
AR5K0807258Medicare Oscar/Certification