Provider Demographics
NPI:1457355174
Name:BUKER, JOHN L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:L
Last Name:BUKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3475 RICHMOND RD
Mailing Address - Street 2:STE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2500
Mailing Address - Country:US
Mailing Address - Phone:859-296-4400
Mailing Address - Fax:859-296-4300
Practice Address - Street 1:3475 RICHMOND RD
Practice Address - Street 2:STE 200
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2500
Practice Address - Country:US
Practice Address - Phone:859-296-4400
Practice Address - Fax:859-296-4300
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2012-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY30380207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000011970OtherCHA PROVIDER NUMBER
KY000000317646OtherANTHEM PROVIDER NUMBER
KY0004122791OtherAETNA PROVIDER NUMBER
KY000000011970OtherCHA PROVIDER NUMBER