Provider Demographics
NPI:1255562005
Name:MARCU BUCK, LAURA (DO)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:MARCU BUCK
Suffix:
Gender:
Credentials:DO
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:MARCU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95 S PAGOSA BLVD
Mailing Address - Street 2:
Mailing Address - City:PAGOSA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81147-8329
Mailing Address - Country:US
Mailing Address - Phone:970-731-3700
Mailing Address - Fax:970-731-0511
Practice Address - Street 1:95 S PAGOSA BLVD
Practice Address - Street 2:
Practice Address - City:PAGOSA SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81147-8329
Practice Address - Country:US
Practice Address - Phone:970-731-3700
Practice Address - Fax:970-731-0511
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-2390-202084N0400X
CODR.00636122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology