Individual
JOHN WILLIAM BUCKELEW JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3133 DENTON PL NE, ROSWELL, GA 30075-6124
(404) 229-1132
(470) 375-3705
Mailing address
3133 DENTON PL NE, ROSWELL, GA 30075-6124
(404) 229-1132
(470) 375-3705
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
976747440-00
UNITED HEALTHCARE
GA
Enumeration date
01/22/2022
Last updated
01/22/2022
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