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Individual

DR. SUSAN H. BUCKNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
355 PRAIRIE AVE, PROVIDENCE, RI 02905-1928
(401) 444-0570
(401) 444-0427
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
(401) 467-6866

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
258441
MA
208000000X
Pediatrics Physician
48331
TN
208000000X
Pediatrics Physician
H4194
TX
208000000X
Pediatrics Physician
Primary
MD15043
RI

Other

Enumeration date
03/18/2014
Last updated
12/14/2023
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