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NPI Code Detail

MEDICARE: BUCKLEY PARKER P.A.

MEDICARE: BUCKLEY PARKER P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant2797TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700266558
Entity Type Code : Individual
Provider Name (Legal Business Name) : BUCKLEY PARKER P.A.
Provider Business Mailing Address
First Line : PO BOX 400
Second Line :
City : JACKSON
State : TN
Zip : 38302-0400
Country : US
Telephone Number : 731-425-5752
Fax Number : 731-425-5783
Provider Business Practice Location Address
First Line : 87 MURRAY GUARD DR STE B
Second Line :
City : JACKSON
State : TN
Zip : 38305-3775
Country : US
Telephone Number : 731-664-1375
Fax Number : 731-660-8319
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2015
Last Update Date : 09/30/2015

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Directions to “ BUCKLEY PARKER P.A.” Practice Location

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