Provider Demographics
NPI:1851749139
Name:BUCK, LARRY CAYCE II (DO)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:CAYCE
Last Name:BUCK
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:PO BOX 23340
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63156-3340
Mailing Address - Country:US
Mailing Address - Phone:314-851-1000
Mailing Address - Fax:314-851-4449
Practice Address - Street 1:3409 UNION BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63115-1127
Practice Address - Country:US
Practice Address - Phone:314-261-4834
Practice Address - Fax:314-383-3970
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2020-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2019024147207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine