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
Fax: (636) 529-7003
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134104466 NPPES
Missouri MEDICAID 1134104466

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