Basic Information
| Provider Information | |||||||||
| NPI: | 1699896159 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUCK | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | CRAIG | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3301 E ELKHORN DR | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680256239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027210090 | ||||||||
| FaxNumber: | 4027219661 | ||||||||
| Practice Location | |||||||||
| Address1: | 3301 E ELKHORN DR | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680256239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027210090 | ||||||||
| FaxNumber: | 4027219661 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2007 | ||||||||
| LastUpdateDate: | 01/17/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 24066 | NE | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | P01670490 | 01 | NE | RR MEDICARE | OTHER | 10026130605 | 05 | NE | MEDICAID | 10025800600 | 05 | NE | MEDICAID | 10026130500 | 05 | NE | MEDICAID | 10026130606 | 05 | NE | MEDICAID | 47063010113 | 05 | NE | MEDICAID | 1699896159 | 05 | IA | MEDICAID |