| Dustan P Buckley Md Pc | |
|
4140 W Memorial Rd Suite 303 Oklahoma City OK 73120-8366 | |
| (405) 749-7030 | |
| (405) 292-5505 |
| Full Name | Dustan P Buckley Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4140 W Memorial Rd, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Dustan P Buckley (PRESIDENT) |
| Authorized Official Contact | 4057497030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dustan P Buckley Md Pc Po Box 3967 Edmond OK 73083-3967 Ph: (405) 749-7030 | Dustan P Buckley Md Pc 4140 W Memorial Rd Suite 303 Oklahoma City OK 73120-8366 Ph: (405) 749-7030 |
| NPI Number | 1174733083 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 08/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174733083 | NPI | - | NPPES |
| 100228630A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 18504 (Oklahoma) | Primary |
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Board Of Regents Of The Univ Of Okla Ou Physicians Employer Spons Clin Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 N Robinson Ave, Suite 200, Oklahoma City, OK 73102 Phone: 405-271-8880 Fax: 405-208-8732 | |
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