Buckelew, Daryl Quintin

Buckelew, Daryl Quintin is an individual health care provider with primary practice located at 3217 Mabel St , Shreveport LA 71103-4022. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Buckelew, Daryl Quintin can be contacted via phone (318) 631-9121.

Contact Information

Primary practice address
3217 Mabel St Shreveport LA 71103-4022
Phone: (318) 631-9121
Fax: (318) 631-9126
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X K6994 Texas
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 340576 Louisiana

Profile Details

NPI number 1588600662
LBN Legal business name Buckelew, Daryl Quintin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Jul 2nd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588600662 NPPES
Louisiana MEDICAID 2654055

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