Provider Demographics
NPI:1083339154
Name:BUCKNER, FRANKI
Entity Type:Individual
Prefix:
First Name:FRANKI
Middle Name:
Last Name:BUCKNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 PEGGY DR
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-1243
Mailing Address - Country:US
Mailing Address - Phone:580-816-0262
Mailing Address - Fax:
Practice Address - Street 1:1002 NE HIGHWAY 66 STE 2
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:OK
Practice Address - Zip Code:73662-9312
Practice Address - Country:US
Practice Address - Phone:580-928-2208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK210111261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care