Individual
DR. WILLIAM J BUCKINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
904 N WISNER ST, JACKSON, MI 49202-3144
(517) 782-9388
(517) 782-9018
Mailing address
904 N WISNER ST, JACKSON, MI 49202-3144
(517) 782-9388
(517) 782-9018
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002686
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22-20017
PHP OF SO MICHIGAN
MI
01
—
900C810950
BCBS OF MICHIGAN
MI
01
—
P00180124
PALMETTO GBA - RAILROAD
—
Enumeration date
09/13/2005
Last updated
03/16/2009
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