Organization
DUSTAN P BUCKLEY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DUSTAN P BUCKLEY MD (PRESIDENT)
(405) 749-7030
Entity
Organization
Contact information
Practice address
4140 W MEMORIAL RD, SUITE 303, OKLAHOMA CITY, OK 73120-8366
(405) 749-7030
(405) 292-5505
Mailing address
PO BOX 3967, EDMOND, OK 73083-3967
(405) 749-7030
(405) 292-5505
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18504
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100228630A
—
OK
Enumeration date
05/23/2007
Last updated
08/22/2011
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