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General NPI Number Information
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NPI Number | 1386733244
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Entity Type | Individual
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Provider Name | MARTHA L BUCKLEY MD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 1550 SHERIDAN DR SUITE 202
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City | LANCASTER
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State | OH
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Zip | 43130-1381
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Country | US
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Telephone | 740-654-0232
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Fax | 740-654-9794
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Provider Business Mailing Address
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Address Line | 805 MOUNT ZION RD SW
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City | LANCASTER
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State | OH
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Zip | 43130-9542
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Country | US
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Telephone | 740-243-5859
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301078318
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License Number State | MI
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