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General NPI Number Information
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NPI Number | 1093566465
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Entity Type | Individual
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Provider Name | CALEB BUCKNER MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | PO BOX 157A
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City | WHITFIELD
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State | MS
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Zip | 39193-0157
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Country | US
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Telephone | 601-351-8555
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 711
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City | BOLTON
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State | MS
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Zip | 39041-0711
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Country | US
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Telephone | 662-418-7819
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | T-5220
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License Number State | MS
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