Individual
DR. PAUL EDWARD BUCKTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
152834-1
NY
2084N0400X
Neurology Physician
Primary
MD014657E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006857800001
—
PA
05
—
00365095
—
NY
01
—
130022275
RR MEDICARE PIN
PA
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039821
MEDICARE GROUP
PA
Enumeration date
02/13/2006
Last updated
06/22/2011
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