Provider Demographics
NPI:1215721055
Name:BUCKLER, COREY JAMES
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:JAMES
Last Name:BUCKLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 OAK ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-5658
Mailing Address - Country:US
Mailing Address - Phone:740-727-1414
Mailing Address - Fax:
Practice Address - Street 1:319 OAK ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-5658
Practice Address - Country:US
Practice Address - Phone:740-727-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide