Individual
DR. JAY CLARK BUCKEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DR, DHMC DEPARTMENT OF MEDICINE, LEBANON, NH 03756-1000
(603) 650-6012
Mailing address
1 MEDICAL CENTER DR, DHMC DEPARTMENT OF MEDICINE, LEBANON, NH 03756-1000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10413
NH
2083A0100X
Aerospace Medicine Physician
10413
NH
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
10413
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0RE5652
—
VT
05
—
30200651
—
NH
Enumeration date
08/30/2006
Last updated
01/30/2019
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