Individual
RONALD BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2000 MEADE PARKWAY, SUFFOLK, VA 23434-4259
(757) 539-0251
(757) 923-9602
Mailing address
PO BOX 7068, PORTSMOUTH, VA 23707-0068
(757) 686-3508
(757) 686-0541
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0102200838
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070013557
RAILROAD MEDICARE
VA
05
—
5901553
—
VA
05
—
690582U
—
NC
Enumeration date
04/22/2006
Last updated
06/24/2020
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