Individual
LAUREN DUANE BUCKINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-3000
Mailing address
2025 E BELTLINE AVE SE STE 310, GRAND RAPIDS, MI 49546-7634
(616) 942-2222
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.005383
IL
Other
Enumeration date
03/19/2015
Last updated
05/05/2016
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