Provider Demographics
NPI:1871023135
Name:BUCK, ZACHARY M (DO)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:M
Last Name:BUCK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2211 E NORTHERN LIGHTS BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4129
Mailing Address - Country:US
Mailing Address - Phone:907-279-8486
Mailing Address - Fax:907-677-5614
Practice Address - Street 1:2211 E NORTHERN LIGHTS BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4129
Practice Address - Country:US
Practice Address - Phone:907-279-8486
Practice Address - Fax:907-677-5614
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDMRO-1658207Q00000X
AK161270207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1707879Medicaid