Provider Demographics
NPI:1720038268
Name:BUCKNELL, ALLAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:L
Last Name:BUCKNELL
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 1:2552 E ALAMEDA AVE
Mailing Address - Street 2:UNIT 118
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-3320
Mailing Address - Country:US
Mailing Address - Phone:303-722-6612
Mailing Address - Fax:
Practice Address - Street 1:2552 E ALAMEDA AVE
Practice Address - Street 2:UNIT 118
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-3320
Practice Address - Country:US
Practice Address - Phone:303-722-6612
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO35145207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery