Provider Demographics
NPI:1336179548
Name:PAUL J KILLIAN ROBERT BUCKINGHAM
Entity Type:Organization
Organization Name:PAUL J KILLIAN ROBERT BUCKINGHAM
Other - Org Name:ARTHRITIS AND RHEUMATIC DISEASE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SPECE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-856-9142
Mailing Address - Street 1:2580 HAYMAKER RD
Mailing Address - Street 2:SUITE102
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3518
Mailing Address - Country:US
Mailing Address - Phone:412-856-9142
Mailing Address - Fax:412-856-9144
Practice Address - Street 1:2580 HAYMAKER RD
Practice Address - Street 2:SUITE102
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3518
Practice Address - Country:US
Practice Address - Phone:412-856-9142
Practice Address - Fax:412-856-9144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA131640Medicare ID - Type Unspecified