Individual
DUSTAN PIERCE BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9100 N MAY AVE, OKLAHOMA CITY, OK 73120
(405) 840-4456
(405) 840-4295
Mailing address
9100 N MAY AVE, OKLAHOMA CITY, OK 73120-4417
(405) 840-4456
(405) 840-4295
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18504
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100228630A
—
OK
01
—
110224377
RAILROAD MEDICARE
OK
Enumeration date
08/16/2005
Last updated
05/16/2018
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