Buckhanan, Earl
Buckhanan, Earl is an individual health care provider with primary practice located at 460 Briarwood Dr Ste 510 , Jackson MS 39206-3057. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Buckhanan, Earl can be contacted via phone (601) 956-4816.Contact Information
Primary practice address
460 Briarwood Dr Ste 510
Jackson MS 39206-3057
Phone: (601) 956-4816
Fax: (601) 956-4817
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
| NPI number | 1548777428 |
|---|---|
| LBN Legal business name | Buckhanan, Earl |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 2nd, 2018 |
| Last updated | Jan 2nd, 2018 - about 7 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548777428 | NPPES |
| Mississippi | MEDICAID | 01670076 |
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