Provider Demographics
NPI:1861824955
Name:BUCKMAN, JONATHAN ASHLEY (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:ASHLEY
Last Name:BUCKMAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 LOCUST GROVE CT
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-9450
Mailing Address - Country:US
Mailing Address - Phone:502-507-5252
Mailing Address - Fax:
Practice Address - Street 1:132 LOCUST GROVE CT
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-9450
Practice Address - Country:US
Practice Address - Phone:502-507-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0166511835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy