Buckle, Raphael A

Buckle, Raphael A is an individual health care provider with primary practice located at 900 Earl Frye Blvd Suite A, Amory MS 38821-5507. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Buckle, Raphael A can be contacted via phone (662) 256-9331.

Contact Information

Primary practice address
900 Earl Frye Blvd Suite A Amory MS 38821-5507
Phone: (662) 256-9331
Fax: (662) 256-9335
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 56408 Georgia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 56408 Georgia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 20416 Mississippi

Profile Details

NPI number 1700867074
LBN Legal business name Buckle, Raphael A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2005
Last updated Mar 2nd, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700867074 NPPES
Other 37BBHBH LEGACY#
Other 1184881229 LEGACY#
MEDICAID 06304211 LEGACY#
Other 1700867074 LEGACY#
MEDICAID 262717777A LEGACY#
Other GRP7462 LEGACY#

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