Individual
RYAN BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
LAMONT STREET AND VETERANS WAY, JOHNSON CITY, TN 37604
(423) 926-1171
Mailing address
123 LAKE HARBOR DR, JOHNSON CITY, TN 37615-2972
(269) 369-0304
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4928
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/17/2010
Last updated
05/24/2024
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