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General NPI Number Information
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NPI Number | 1386813871
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Entity Type | Organization
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Legal Business Name | DRS. RICHARD & PHYLLIS BUCKWALTER
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | WELSH ROAD AT INVERNESS DRIVE
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City | HORSHAM
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State | PA
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Zip | 19044-1801
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Country | US
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Telephone | 215-659-1113
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Fax |
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Provider Business Mailing Address
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Address Line | WELSH ROAD AT INVERNESS DRIVE
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City | HORSHAM
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State | PA
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Zip | 19044-1801
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING CLERK
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Name | MRS. TAMMIE BUCKWALTER
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Credential |
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Telephone | 215-659-1113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD25525L
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License Number State | PA
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