Individual
JAMES RAYMOND BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1040 W WASHINGTON ST, MARSHFIELD, MO 65706-2314
(417) 859-2380
Mailing address
1040 W WASHINGTON ST, MARSHFIELD, MO 65706-2314
(417) 859-2380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2009032049
MO
390200000X
Student in an Organized Health Care Education/Training Program
R929
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407030349
—
MO
01
—
431560263
TRICARE WEST
—
01
—
P00773390
RAILROAD MEDICARE
MO
Enumeration date
12/27/2007
Last updated
12/23/2019
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