Individual
RYAN BUCKNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4613
(719) 526-2273
Mailing address
1650 COCHRANE CIR, FORT CARSON, CO 80913-4613
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
30755
NE
207X00000X
Orthopaedic Surgery Physician
Primary
94486
GA
Other
Enumeration date
04/17/2016
Last updated
03/26/2024
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