Buckley, Jennifer Louise

Buckley, Jennifer Louise is an individual health care provider with primary practice located at 835 Cogburn Ave Nw Suite 100, Marietta GA 30060-1031. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Buckley, Jennifer Louise can be contacted via phone (770) 422-5557.

Contact Information

Primary practice address
835 Cogburn Ave Nw Suite 100 Marietta GA 30060-1031
Phone: (770) 422-5557
Fax: (770) 422-5456
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 051441 Georgia

Profile Details

NPI number 1215908652
LBN Legal business name Buckley, Jennifer Louise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated Jun 12th, 2020 - about 4 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 1215908652 NPPES
Georgia Other P00121329 RAILROAD MEDICARE

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