Provider Demographics
NPI:1306822846
Name:BUCKLEY, ROBERT HOBSON (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HOBSON
Last Name:BUCKLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 827 BOX 273
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09617-1000
Mailing Address - Country:IT
Mailing Address - Phone:0113-908-1811
Mailing Address - Fax:01139081-811-6479
Practice Address - Street 1:PSC 827 BOX 273
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09617-1000
Practice Address - Country:IT
Practice Address - Phone:0113-908-1811
Practice Address - Fax:01139081-811-6479
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000327582080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD00032758OtherMEDICAL LICENSE
ARC7464OtherMEDICAL LICENSE