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General NPI Number Information
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NPI Number | 1922064336
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Entity Type | Individual
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Provider Name | REGINA BUCKLEY DANDY DO
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Gender | Female
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 89 INTERCHANGE DR
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City | RICHMOND HILL
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State | GA
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Zip | 31324-7661
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Country | US
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Telephone | 912-527-5301
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Fax | 912-756-4740
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Provider Business Mailing Address
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Address Line | PO BOX 15849
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City | SAVANNAH
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State | GA
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Zip | 31416-2549
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Country | US
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Telephone | 912-527-5301
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Fax | 912-756-4740
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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 | 057286
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License Number State | GA
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