Individual
DR. CARL LOUIS BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-3100
Mailing address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-3100
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
2009-01192
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1531C
BLUE CROSS BLUE SHIELD NC
NC
05
—
5912236
—
NC
01
—
P00750150
RAILROAD MEDICARE
—
Enumeration date
11/03/2006
Last updated
11/10/2009
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