Individual
DR. LYNN RANDOLPH BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1405 7TH STREET SE, DECATUR, AL 35601-3341
(256) 355-6414
(256) 355-6646
Mailing address
PO BOX 1029, DECATUR, AL 35602-1029
(256) 355-6414
(256) 355-6646
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00016036
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000025530
—
AL
01
—
1710268
UNITED HEALTH
AL
01
—
51025530BUC
BCBS
AL
01
—
990010719
RR MEDICARE
AL
Enumeration date
05/11/2006
Last updated
01/27/2010
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