Buckley, Brenda Lynn
Buckley, Brenda Lynn is an sole proprietor health care provider with primary practice located at 1747 Smizer Station Rd Suite 5, Fenton MO 63026-2784. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Buckley, Brenda Lynn can be contacted via phone (636) 529-7000.Contact Information
Primary practice address
1747 Smizer Station Rd Suite 5
Fenton MO 63026-2784
Phone: (636) 529-7000
Fax: (636) 529-7003
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 115447 | Missouri |
Profile Details
| NPI number | 1134104466 |
|---|---|
| LBN Legal business name | Buckley, Brenda Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 9th, 2005 |
| Last updated | Feb 1st, 2016 - about 10 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 | 1134104466 | NPPES |
| Missouri | MEDICAID | 1134104466 |
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