Individual
DR. THERESA A BUCKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6200 SW 73RD ST, SOUTH MIAMI, FL 33143-4679
(786) 662-4000
Mailing address
777 LOWNDES HILL RD BLDG 1, GREENVILLE, SC 29607-2101
(864) 908-3530
(864) 627-9920
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
D0056988
MD
207V00000X
Obstetrics & Gynecology Physician
Primary
ME140849
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
693501000
—
MD
Enumeration date
12/22/2005
Last updated
09/05/2023
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