Individual
DR. GOLDEN THADDEUS BUCKLAND III
Active
Individual
DR. GOLDEN THADDEUS BUCKLAND III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M9945
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010162794
BLUE SHIELD
—
01
—
1100054
MEDICARE
—
01
—
1518003516
NORTH IDAHO CATARACT & LA
—
01
—
76960
BLUE CROSS OF IDAHO
—
05
—
807806900
—
ID
Enumeration date
06/01/2007
Last updated
05/01/2024
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