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General NPI Number Information
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NPI Number | 1528053212
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Entity Type | Individual
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Provider Name | ANTHONY L. BUCKLES MD
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Gender | Male
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 105 NORTHGATE RD STE D
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City | NATCHEZ
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State | MS
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Zip | 39120-9162
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Country | US
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Telephone | 769-355-2052
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Fax | 304-803-3716
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Provider Business Mailing Address
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Address Line | 105 NORTHGATE RD STE D
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City | NATCHEZ
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State | MS
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Zip | 39120-9162
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Country | US
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Telephone | 769-355-2052
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Fax | 304-803-3716
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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 | 036-106738
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20937
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License Number State | MS
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