Provider Demographics
NPI:1710033303
Name:BUCKLEY, LINDA L (MD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 E HAMPDEN AVE STE 525
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2786
Mailing Address - Country:US
Mailing Address - Phone:303-321-2644
Mailing Address - Fax:303-321-2446
Practice Address - Street 1:799 E HAMPDEN AVE STE 525
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2786
Practice Address - Country:US
Practice Address - Phone:303-321-2644
Practice Address - Fax:303-321-2446
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO41513207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00629122OtherRAILROAD MEDICARE
CO25739034Medicaid
COI47143Medicare UPIN
COC809737Medicare PIN