Provider Demographics
NPI:1265873681
Name:BUCKLEY, ELAINE JAYNE CATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:ELAINE JAYNE
Middle Name:CATHERINE
Last Name:BUCKLEY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-254-7980
Mailing Address - Fax:651-254-7990
Practice Address - Street 1:640 JACKSON ST # MS 11502V
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101
Practice Address - Country:US
Practice Address - Phone:651-254-7980
Practice Address - Fax:651-254-7990
Is Sole Proprietor?:No
Enumeration Date:2013-07-14
Last Update Date:2019-07-22
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Provider Licenses
StateLicense IDTaxonomies
IL125.063949208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery