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General NPI Number Information
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NPI Number | 1215040001
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Entity Type | Individual
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Provider Name | MICHAEL A. BUCKLEY D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 11/23/2010
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Provider Practice Location Address
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Address Line | PSC 490 ANESTHESIOLOGY
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City | FPO
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State | AP
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Zip | 96538-0490
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Country | US
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Telephone | 671-344-9419
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 490 PO BOX 9006
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City | FPO
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State | AP
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Zip | 96538-0490
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Country | US
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Telephone | 671-344-9419
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20A8513
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 20A8513
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 20A8513
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License Number State | CA
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