Individual
REGINA BUCKLEY DANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
89 INTERCHANGE DR, RICHMOND HILL, GA 31324-7661
(912) 527-5301
(912) 756-4740
Mailing address
PO BOX 15849, SAVANNAH, GA 31416-2549
(912) 527-5301
(912) 756-4740
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
057286
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046401246A
—
GA
05
—
046401246B
—
GA
05
—
046401246C
—
GA
05
—
046401246D
—
GA
01
—
10069519
AMERIGROUP
GA
01
—
404141
WELLCARE
GA
01
—
52206024-001
BCBS GA
GA
01
—
CH5121
RR MEDICARE GROUP ID
GA
05
—
G57286
—
SC
01
—
GRP3905
GA MEDICARE GROUP ID
GA
01
—
P00394151
RR MEDICARE
GA
Enumeration date
04/25/2006
Last updated
09/02/2016
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