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Individual

DR. JOHN BUCKNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
6757 W NEWBERRY RD, GAINESVILLE, FL 32605
(352) 331-2040
(352) 331-1526
Mailing address
6757 W NEWBERRY RD, GAINESVILLE, FL 32605
(352) 331-2040
(352) 331-1526

Taxonomy

Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
792
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
084305900
FL
01
421588508
TAX ID
FL
01
796
FLORDIA LIC NUMBER
FL
Enumeration date
02/21/2007
Last updated
02/11/2011
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