Individual
JEREMY BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2405 N COLUMBUS ST, SUITE 100, LANCASTER, OH 43130-8185
(740) 689-4480
(740) 277-7692
Mailing address
1153 E MAIN ST, PO BOX 2563, LANCASTER, OH 43130-4056
(740) 687-8990
(740) 687-8230
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35093475
OH
207RC0000X
Cardiovascular Disease Physician
Primary
35093475
OH
207RI0011X
Interventional Cardiology Physician
35093475
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2954905
—
OH
Enumeration date
03/26/2007
Last updated
09/30/2016
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