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Organization
ALLERGY & ASTHMA ASSOCIATES LLC
Active
Organization
ALLERGY & ASTHMA ASSOCIATES LLC
Active
Other names
DR RAPHAEL A BUCKLE
Organization subpart
No
Provider details
NPI number
Authorized official
LENA BUCKLE (MANAGER)
(770) 529-0460
Entity
Organization
Contact information
Practice address
3104 CREEKSIDE VILLAGE DR NW, SUITE 201, KENNESAW, GA 30144-2324
(770) 529-0460
Mailing address
3104 CREEKSIDE VILLAGE DRIVE, SUITE 201, KENNESAW, GA 30144-2334
(770) 529-0460
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
56408
GA
208000000X
Pediatrics Physician
56408
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700867074
INDIVIDUAL NPI
GA
05
—
262717777A
—
GA
01
—
GRP7462
MEDICARE LEGACY NUMBER
GA
Enumeration date
05/16/2008
Last updated
05/16/2008
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