Individual
DR. STEPHEN LESLIE BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 PALM AVE, JACKSONVILLE, FL 32207-8432
(904) 202-7300
(904) 202-7433
Mailing address
PO BOX 45278, JACKSONVILLE, FL 32232-5278
(904) 202-2092
(904) 393-7603
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
ME68241
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146316572D
—
GA
05
—
258772600
—
FL
01
—
P01265837
RR MEDICARE
FL
Enumeration date
05/06/2006
Last updated
12/12/2019
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