Individual
MR. MARK C BUCKINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Contact information
Practice address
11408 W 135TH ST, OVERLAND PARK, KS 66221-9398
(913) 681-9909
(913) 681-9906
Mailing address
15415 NEWTON DR, OVERLAND PARK, KS 66223-2847
(913) 706-6564
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03234
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31489
FREEDOM NETWORK
KS
01
—
31489037
BCBS
KS
Enumeration date
07/20/2006
Last updated
09/24/2015
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