W. Bruce Bucklew, MD, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

W. BRUCE BUCKLEW, MD, PLLC

Practice address

5860 S Hospital Dr
Suite 106
Globe, AZ 85501-9449

Phone

(928) 402-1168

Fax

(928) 402-1119

NPI assigned

Jan 4, 2011

Last updated

Jan 4, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

DD Sande

Title

Credentialing Manager

Phone

(520) 409-3445

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1093019119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 S HOSPITAL DR",
            "address_2": "SUITE 106",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855019449",
            "telephone_number": "928-402-1168",
            "fax_number": "928-402-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 S HOSPITAL DR",
            "address_2": "SUITE 106",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855019449",
            "telephone_number": "928-402-1168",
            "fax_number": "928-402-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. BRUCE BUCKLEW, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "SANDE",
        "authorized_official_first_name": "DD",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "520-409-3445"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bradley H Werrell, DO
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• Thea W. Wilshire, PHD
• Taelor Winkowski
• James L Woolf, DDS

• Medical Specialty Clinic/Center in Globe, AZ
• Providers in Globe, AZ by specialty
• Medical Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.