Dr Raphael A Buckle, MD | |
900 Earl Frye Blvd, Suite A, Amory, MS 38821-5507 | |
(662) 256-9331 | |
(662) 256-9335 |
Full Name | Dr Raphael A Buckle |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 900 Earl Frye Blvd, Amory, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700867074 | NPI | - | NPPES |
37BBHBH | Other | LEGACY# | |
1184881229 | Other | GA | ORG NPI |
06304211 | Medicaid | MS | |
1700867074 | Other | NPI | |
262717777A | Medicaid | GA | |
GRP7462 | Other | GROUP# |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207K00000X | Allergy & Immunology | 56408 (Georgia) | Secondary |
208000000X | Pediatrics | 56408 (Georgia) | Secondary |
208000000X | Pediatrics | 20416 (Mississippi) | Primary |
Entity Name | Emergency Coverage Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20050411000056 |
Entity Name | The Bortolazzo Group, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801965082 PECOS PAC ID: 3476554320 Enrollment ID: O20070122000015 |
Entity Name | Emergency Group Of Columbus Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316458227 PECOS PAC ID: 2668735515 Enrollment ID: O20180406001191 |
Mailing Address | Practice Location Address |
---|---|
Dr Raphael A Buckle, MD 900 Earl Frye Blvd, Suite A, Amory, MS 38821-5507 Ph: (662) 256-9331 | Dr Raphael A Buckle, MD 900 Earl Frye Blvd, Suite A, Amory, MS 38821-5507 Ph: (662) 256-9331 |
Dr. Terry William Odom, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 702 Earl Frye Blvd, Amory, MS 38821 Phone: 662-256-9391 Fax: 662-256-4307 | |
Thomas Henry Kloor Jr., MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1105 Earl Frye Blvd, Amory, MS 38821 Phone: 662-256-7111 | |
Zhear Al-godi, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1107 Earl Frye Blvd, Suite 5, Amory, MS 38821 Phone: 662-257-6705 | |
Dr. Donald Carlisle Livingston, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 900 Earl Frye Blvd Ste A, Amory, MS 38821 Phone: 662-256-9331 Fax: 662-256-9349 | |
Dr. Jason Doyle Simpson, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 900 Earl Frye Blvd, Amory, MS 38821 Phone: 662-256-9331 | |
Mrs. Mary Ann King, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 900 Earl Frye Blvd, Suite A, Amory, MS 38821 Phone: 662-256-9331 Fax: 662-256-9349 | |
John R Mcpherson, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 900 Earl Frye Blvd Ste A, Amory, MS 38821 Phone: 662-256-9331 Fax: 662-597-6008 |