Provider Demographics
NPI:1538326939
Name:BUCKNER CHIROPRACTIC CENTER, INC.
Entity Type:Organization
Organization Name:BUCKNER CHIROPRACTIC CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:NOLEN
Authorized Official - Last Name:BUCKNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:256-895-0606
Mailing Address - Street 1:2605 OLD FAIRWAY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35806-6401
Mailing Address - Country:US
Mailing Address - Phone:256-895-0606
Mailing Address - Fax:256-895-6400
Practice Address - Street 1:2605 OLD FAIRWAY RD STE 100
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-6401
Practice Address - Country:US
Practice Address - Phone:256-895-0606
Practice Address - Fax:256-895-6400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000091720Medicare PIN
ALU79678Medicare UPIN