Individual
JACOB BUCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3652 STARDUST DR, HANNIBAL, MO 63401-6212
(573) 221-8800
Mailing address
3652 STARDUST DR, HANNIBAL, MO 63401-6212
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
2013025658
MO
Other
Enumeration date
01/13/2014
Last updated
01/13/2014
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