Individual
DR. JACKSON THOMAS LEE BUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2277 SWANSON AVE STE 100, LAKE HAVASU CITY, AZ 86403-6141
(928) 706-9991
Mailing address
2277 SWANSON AVE STE 100, LAKE HAVASU CITY, AZ 86403-6141
(928) 706-9991
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-002704
AZ
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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