Individual
DR. KEVIN BUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
975 S FAIRMONT AVE, LODI, CA 95240-5118
(209) 339-7575
Mailing address
5937 CUMBERLAND PL, STOCKTON, CA 95219-3818
(209) 610-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A33983
CA
2083X0100X
Occupational Medicine Physician
A33983
CA
Other
Enumeration date
07/24/2006
Last updated
11/02/2011
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