# BUCKNER VEIN AND AESTHETICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518563790
- **Authorized official:** SCOTT BUCKNER MD (OWNER)
- **Authorized official phone:** (240) 913-5900

## Contact information

- **Practice address:** 1330 LIBERTY RD, SUITE H, ELDERSBURG, MD 21784-6412
- **Practice address phone:** (240) 913-5900
- **Practice address fax:** (240) 913-5901
- **Mailing address:** 1330 LIBERTY RD, SUITE H, ELDERSBURG, MD 21784-6412
- **Mailing address phone:** (240) 913-5900
- **Mailing address fax:** (240) 913-5901

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2020
- **Last updated:** 12/22/2020