Individual
DR. BRADLEY C BUCKHOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
650 E INDIAN SCHOOL RD, CLC, PHOENIX, AZ 85012-1839
(602) 277-5551
(602) 200-6039
Mailing address
650 E INDIAN SCHOOL RD, CLC, PHOENIX, AZ 85012-1839
(602) 277-5551
(602) 200-6039
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
13405
AZ
207QG0300X
Geriatric Medicine (Family Medicine) Physician
13405
AZ
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
13405
AZ
Other
Enumeration date
05/16/2006
Last updated
01/08/2015
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