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General NPI Number Information
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NPI Number | 1467448555
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Entity Type | Individual
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Provider Name | RONALD J BUCKLEY MD
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 1210 HANOVER AVE
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City | ALLENTOWN
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State | PA
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Zip | 18109-2017
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Country | US
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Telephone | 610-437-6490
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Fax | 610-437-4151
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Provider Business Mailing Address
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Address Line | 421 W CHEW ST
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City | ALLENTOWN
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State | PA
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Zip | 18102-3406
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Country | US
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Telephone | 610-776-5315
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Fax | 610-663-3113
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD020876E
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License Number State | PA
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