Individual
ANDREW D BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2032 TWAIN RIDGE DR, LEXINGTON, KY 40514-1325
(989) 780-0613
Mailing address
2032 TWAIN RIDGE DR, LEXINGTON, KY 40514-1325
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
03875
KY
207Q00000X
Family Medicine Physician
0116024155
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100382300
—
KY
Enumeration date
04/05/2012
Last updated
03/03/2025
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