Healthcare Provider Details

I. General information

NPI: 1598704645
Provider Name (Legal Business Name): WILLIAM E BUCKNER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 EAST MAIN STREET
EPHRATA PA
17522-2545
US

IV. Provider business mailing address

895 EAST MAIN STREET
EPHRATA PA
17522-2545
US

V. Phone/Fax

Practice location:
  • Phone: 717-721-4585
  • Fax: 717-721-4597
Mailing address:
  • Phone: 717-721-4585
  • Fax: 717-721-4597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA052332
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: