Provider Demographics
NPI:1972550457
Name:BUCKLAND, ROBERT W (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:W
Last Name:BUCKLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1002 SIOUX LN
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6774
Mailing Address - Country:US
Mailing Address - Phone:308-532-6163
Mailing Address - Fax:308-534-3813
Practice Address - Street 1:516 W LEOTA ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6533
Practice Address - Country:US
Practice Address - Phone:308-534-5370
Practice Address - Fax:308-534-3813
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12152208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEE38554Medicare UPIN
NE097794Medicare ID - Type UnspecifiedPROVIDER ID