Provider Demographics
NPI:1669647574
Name:DR. JAMES F. BUCKNER, JR
Entity Type:Organization
Organization Name:DR. JAMES F. BUCKNER, JR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DIGIUSEPPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-586-3937
Mailing Address - Street 1:PO BOX 2804
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42135-2804
Mailing Address - Country:US
Mailing Address - Phone:270-586-3937
Mailing Address - Fax:
Practice Address - Street 1:1300 BLUEGRASS RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-1981
Practice Address - Country:US
Practice Address - Phone:270-586-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1148DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY410017878OtherRAILROAD MEDICARE
KY000000049744OtherBCBS
KY77011484Medicaid
KYT19564Medicare UPIN
KY410017878OtherRAILROAD MEDICARE
KY9307801Medicare PIN