Individual
DR. GOLDEN THADDEUS BUCKLAND III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1814 LINCOLN WAY, COEUR D ALENE, ID 83814-2540
(208) 667-2531
(208) 765-9385
Mailing address
1814 LINCOLN WAY, COEUR D ALENE, ID 83814-2540
(208) 667-2531
(208) 765-9385
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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