Individual
MRS. LINDSEY BUCKLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
903 S STATE ST, JERSEYVILLE, IL 62052-2344
(618) 639-9255
(618) 639-8100
Mailing address
261 COVENTRY PL, EDWARDSVILLE, IL 62025-1507
(618) 946-0299
(618) 498-8439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007107
IL
363A00000X
Physician Assistant
2015007736
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508258393
—
MO
Enumeration date
03/03/2015
Last updated
06/19/2023
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