Healthcare Provider Details

I. General information

NPI: 1700013570
Provider Name (Legal Business Name): DAVID D BUCKLAND D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1918 MASONS BEND DR
FORT MILL SC
29708-7061
US

IV. Provider business mailing address

1665 HERLONG COURT SUITE B
ROCK HILL SC
29732
US

V. Phone/Fax

Practice location:
  • Phone: 803-412-4720
  • Fax: 803-547-6734
Mailing address:
  • Phone: 803-980-7945
  • Fax: 803-366-6155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number40761
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number7847
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: