Individual
DR. CARLOS L. BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5880 ENTERPRISE STE 400, CASPER, WY 82609-4295
(307) 333-6567
(307) 265-2860
Mailing address
PO BOX 128, BELLAIRE, TX 77402-0128
(281) 833-3330
(281) 833-3323
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
8683A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8683A
WY MEDICAL LICENSE
WY
Enumeration date
11/09/2007
Last updated
06/12/2020
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