Individual
DIANE BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 ROSE ST, LEXINGTON, KY 40536-7001
(859) 562-1085
(859) 257-5152
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
42228
KY
208000000X
Pediatrics Physician
53792
KY
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
53792
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2017
Last updated
05/24/2023
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