Individual
JAMIE JERROD BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
735 NORTH DR, HOPKINSVILLE, KY 42240-2620
(270) 886-5163
(270) 886-5178
Mailing address
3999 FORT CAMPBELL BLVD, HOPKINSVILLE, KY 42240-4929
(270) 886-2205
(270) 886-0392
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
252216
KY
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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