Individual
JASON ROBERT BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
LL30988
SC
2080P0202X
Pediatric Cardiology Physician
30988
SC
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
30988
SC
Other
Enumeration date
06/07/2008
Last updated
10/24/2017
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