Buck, Brian Gordon

Buck, Brian Gordon is an individual health care provider with primary practice located at 705 Dixie St , Carrollton GA 30117-3818. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Buck, Brian Gordon can be contacted via phone (770) 812-5730.

Contact Information

Primary practice address
705 Dixie St Carrollton GA 30117-3818
Phone: (770) 812-5730
Fax: (770) 838-8563
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN099295 Georgia

Profile Details

NPI number 1346222056
LBN Legal business name Buck, Brian Gordon
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Nov 22nd, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346222056 NPPES
Georgia MEDICAID 491431789A
Georgia MEDICAID 000578586C

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