Robert Buckman
Individual provider Active NPI Counselor · Broken Bow, OK
NPI 1235745472 · NPPES record last updated Sep 22, 2020
Key facts
- NPI
- 1235745472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 111 Esplanade Dr
Broken Bow, OK 74728-6103 - Phone
- (580) 236-6359
- NPI assigned
- Sep 22, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
111 Esplanade Dr
Broken Bow, OK 74728-6103
Mailing address
111 Esplanade Dr
Broken Bow, OK 74728-6103
Phone (580) 236-6359
Other providers in Broken Bow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.