Individual
DR. ULISA DIANE BUCKINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 MAINE ST, BERT NASH, LAWRENCE, KS 66044-1368
(785) 843-9192
Mailing address
PO BOX 25173, OVERLAND PARK, KS 66225-5173
(913) 791-1292
(913) 469-6440
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
04-23312
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-2932962
FEDERAL TAX ID
KS
Enumeration date
08/21/2006
Last updated
04/10/2015
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