Buckner, Irene
Buckner, Irene is an sole proprietor health care provider with primary practice located at 1967 Hospital Dr , Clarksdale MS 38614. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Buckner, Irene can be contacted via phone (662) 624-5481.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 16074 | Mississippi |
Profile Details
| NPI number | 1003836669 |
|---|---|
| LBN Legal business name | Buckner, Irene |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2006 |
| Last updated | Jan 14th, 2019 - about 6 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 | 1003836669 | NPPES |
| Mississippi | MEDICAID | 00119669 |
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