Provider Demographics
NPI:1801856943
Name:BUCK, SCOTT A (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:BUCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:851 EASTPORT CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2909
Mailing Address - Country:US
Mailing Address - Phone:219-464-8223
Mailing Address - Fax:219-531-2356
Practice Address - Street 1:851 EASTPORT CENTRE DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2909
Practice Address - Country:US
Practice Address - Phone:219-464-8223
Practice Address - Fax:219-531-2356
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01048897A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200311720Medicaid
IN180043158Medicare PIN
IN180230DMedicare PIN
H35682Medicare UPIN