Provider Demographics
NPI:1841218641
Name:BUCKLEY, CONOR P (MD)
Entity Type:Individual
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First Name:CONOR
Middle Name:P
Last Name:BUCKLEY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:780 KUENZLI STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-0837
Mailing Address - Country:US
Mailing Address - Phone:775-982-4590
Mailing Address - Fax:775-982-4595
Practice Address - Street 1:75 PRINGLE WAY
Practice Address - Street 2:STE 512
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1464
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-786-7216
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-02-27
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Provider Licenses
StateLicense IDTaxonomies
NV4115207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2016502Medicaid
C95837Medicare UPIN
NV2016502Medicaid