Individual
MICHAEL RONALD BUCKMASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
3505 S REED RD, KOKOMO, IN 46902-3838
(765) 453-8666
(765) 453-8506
Mailing address
3505 S REED RD, KOKOMO, IN 46902-3838
(765) 453-8666
(765) 453-8506
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
28142494A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200941760
—
IN
Enumeration date
05/15/2008
Last updated
12/16/2013
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