MEDICARE: KELLI SUZANNE BUCKNER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	34.010614	OH

General Provider Information

NPI Number	:	1417269622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLI SUZANNE BUCKNER DO

Provider Business Mailing Address
First Line	:	13438 SEBE DR
Second Line	:
City	:	MARSHALLVILLE
State	:	OH
Zip	:	44645-9767
Country	:	US
Telephone Number	:	303-278-6263
Fax Number	:

Provider Business Practice Location Address
First Line	:	16888 HARVARD AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-2208
Country	:	US
Telephone Number	:	330-323-3060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2010
Last Update Date	:	09/01/2021

Similar Medicare Providers

1326241852 — MS. RUTH A CHAZA-NDLOVU CNP
Practice Location Address:

16888 HARVARD AVE
CLEVELAND, OH
44128-2208

Practice Phone: 216-682-7703
Practice Fax: 216-236-7768

1760688030 — DAVE'S SUPERMARKETS INC
Practice Location Address:

16820 HARVARD AVE
CLEVELAND, OH
44128-2208

Practice Phone: 216-991-8648
Practice Fax: 216-991-8655

1073904520 — JENNIFER STAUFFER FNP
Practice Location Address:

16888 HARVARD AVE
CLEVELAND, OH
44128-2208

Practice Phone: 216-810-7159
Practice Fax: 216-920-6286

1295589216 — RACHEL BERGMAN APRN
Practice Location Address:

16888 HARVARD AVE
CLEVELAND, OH
44128-2208

Practice Phone: 216-810-7159
Practice Fax:

1548376130 — DR. JUAN ERNESTO BAHAMON M.D.
Practice Location Address:

1 COUNTY ROAD 2208 2
CLEVELAND, TX
77327-2309

Practice Phone: 210-776-4058
Practice Fax:

1710028774 — DR. MYRON BUD STERN PH.D.
Practice Location Address:

50 PUBLIC SQ , TERMINAL TOWER, STE. 852
CLEVELAND, OH
44113-2208

Practice Phone: 216-579-0560
Practice Fax: 216-579-0544

Directions to “ KELLI SUZANNE BUCKNER DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.