Provider Demographics
NPI:1720059462
Name:BUCKNER, AYANNA V (MD)
Entity Type:Individual
Prefix:
First Name:AYANNA
Middle Name:V
Last Name:BUCKNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:80 JESSE HILL DR DR SE
Mailing Address - Street 2:PO BOX 26042
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-616-1000
Mailing Address - Fax:404-489-6820
Practice Address - Street 1:1595 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-3200
Practice Address - Country:US
Practice Address - Phone:404-616-2886
Practice Address - Fax:404-209-1769
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2018-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0569662083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine