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Individual

BILLY M BUCKNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4600 HIGHWAY 280 STE 100, BIRMINGHAM, AL 35242-5185
(205) 408-1231
(205) 408-1229
Mailing address
1 W LAKESHORE DR STE 100, BIRMINGHAM, AL 35209-7271
(205) 547-3996
(205) 408-1231

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD.13367
AL
207R00000X
Internal Medicine Physician
Primary
13367
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000061818
AL
01
1699756973
TRICARE SOUTH
AL
01
510-61818
BCBS
AL
05
A14431C
AL
Enumeration date
11/14/2005
Last updated
01/12/2022
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