Individual
CHANNING F BUCKLEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
14994 W MAIN ST, LOUISVILLE, MS 39339-2616
(662) 773-3494
Mailing address
14994 W MAIN ST, LOUISVILLE, MS 39339-2616
(662) 446-9000
(662) 779-4030
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
998
MS
Other
Enumeration date
08/05/2019
Last updated
05/24/2022
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