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DR. RAPHAEL A BUCKLE MD

>> Allergy & Immunology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1700867074

Individual Registrant:
DR. RAPHAEL A BUCKLE MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
900 EARL FRYE BLVD SUITE A AMORY, MS 38821-5507 US
Tel: 662-256-9331  Fax: 662-256-9335

Contact information for business:
900 EARL FRYE BLVD SUITE A AMORY, MS 38821-5507 US
Tel: 662-256-9331  Fax: 662-256-9336

Registration Information:
NPI: 1700867074
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207K00000XAllopathic & Osteopathic Physicians
Allergy & Immunology
GA56408
N208000000XAllopathic & Osteopathic Physicians
Pediatrics
GA56408
Y208000000XAllopathic & Osteopathic Physicians
Pediatrics
MS20416

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
NPI170086707401
LEGACY#37BBHBH01
ORG NPI1184881229GA01
06304211MS05
262717777AGA05
GROUP#GRP746201




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