NPIMap

Organization Active NPI

Dodge City Medical Clinic, Inc.

  • Primary Care Clinic/Center
  • Hanceville, AL
National Provider Identifier
1407976624
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MD27216 Issued in AL
Legal business name
DODGE CITY MEDICAL CLINIC, INC.
Practice address
561 Al Highway 69 S
Suite B
Hanceville, AL 35077-3403
Phone
(256) 287-2345
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard Anthony Bucco Jr., MD, PHD
Title
President
Phone
(256) 287-2345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MD27216 AL Primary

Addresses

Primary practice location

561 Al Highway 69 S
Suite B
Hanceville, AL 35077-3403

Mailing address

PO Box 1208
Cullman, AL 35056-1208
Phone (256) 287-2345

National Provider Directory

National Provider Directory

Locations

561 AL Highway 69 S
#B
Hanceville, AL 35077
Phone (256) 287-2345

24 County Road 262
Hanceville, AL 35077
Phone (256) 287-2345

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1407976624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1208",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350561208",
            "telephone_number": "256-287-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 AL HIGHWAY 69 S",
            "address_2": "SUITE B",
            "city": "HANCEVILLE",
            "state": "AL",
            "postal_code": "350773403",
            "telephone_number": "256-287-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODGE CITY MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "BUCCO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-287-2345",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AL",
            "license": "MD27216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanceville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.