Derek S Buck (NPI# 1790951432, PAC ID# 9638147382) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1790951432 |
| PAC ID by PECOS | 9638147382 |
| Professional Enrollment ID | I20120907000758 |
| Full Name | Derek S Buck |
| Organization Legal Name | SIDELINE ORTHOPEDICS AND SPORTS MEDICINE LLC |
| Address |
111 Sanders Ln Bluefield VA 24605-9278 |
| Phone Number | 5405527133 |
| Gender | M |
| Credential | DC |
| Graduation Year | 2008 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 3072801612 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 510071 | BLUEFIELD REGIONAL MEDICAL CENTER |
| 490110 | LEWISGALE HOSPITAL MONTGOMERY |
| 490111 | WYTHE COUNTY COMMUNITY HOSPITAL |
| 490116 | LEWISGALE HOSPITAL PULASKI |
| 510046 | PRINCETON COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1000 Vermillion St, Athens, WV 24712-9027 | 5405527133 | SIDELINE ORTHOPEDICS AND SPORTS MEDICINE LLC |
| 111 Sanders Ln, Bluefield, VA 24605-9278 | 5405527133 | SIDELINE ORTHOPEDICS AND SPORTS MEDICINE LLC |
| Organization Legal Name | SIDELINE ORTHOPEDICS AND SPORTS MEDICINE LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jordan Nelson Gibson | Physical Therapy | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Kayla Danielle Owata | Physical Therapy | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Elizabeth Denton Ashe | Physician Assistant | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Bart L Eastwood | Orthopedic Surgery | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Matthew Scott Shortt | Physician Assistant | Sideline Orthopedics and Sports Medicine LLC | 250 S Main St, Suite 224a, Blacksburg, VA 24060-4725 |
| Street Address |
111 SANDERS LN |
| City | BLUEFIELD |
| State | VA |
| Zip | 24605-9278 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frederick William Barker | General Surgery | Unit 101 Westwood Commons, Westwood Medical Park, Bluefield, VA 24605 | |
| Anthony D Rasi | General Practice | Infinity Medical Management, LLC | 231 Medical Park Dr, Suite 300, Bluefield, VA 24605-1531 |
| Vijaykumar R Phade | General Surgery | 234 Medical Park Dr, Suite 100, Bluefield, VA 24605-1532 | |
| Jonathan R Hall | Internal Medicine | Derm One Pllc | 725 S College Ave, Bluefield, VA 24605-1640 |
| Alfred J Dyer | Physical Therapy | 134 S College Ave, Bluefield, VA 24605-1705 | |
| Catherine L Gillespie | Qualified Speech Language Pathologist | 108 /2 Spruce St, Bluefield, VA 24605-1738 | |
| Thomas E Brinegar | Family Medicine | 112 Spruce St, Suite 1, Bluefield, VA 24605-1755 | |
| Hiep V Le | Family Medicine | 12 Westwood Medical Park, Bluefield, VA 24605-2000 | |
| Stephen Degray | Family Medicine | 7 Westwood Medical Park, Bluefield, VA 24605-2000 | |
| Jeffrey A. Williams | Chiropractic | 1 Westwood Medical Park, Bluefield, VA 24605-2000 | |
| Find all physicians in zip 24605 | |||
| City | BLUEFIELD |
| Zip Code | 24605 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | BLUEFIELD + PHYSICAL MEDICINE AND REHABILITATION |
Please comment or provide details below to improve the information on Derek S Buck.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.