Provider Demographics
NPI:1770393654
Name:BUCKNER, JOHN (PA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:BUCKNER
Suffix:
Gender:M
Credentials:PA
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2409 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52737-9302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2409 SPRING ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS CITY
Practice Address - State:IA
Practice Address - Zip Code:52737-9302
Practice Address - Country:US
Practice Address - Phone:319-728-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant