Cornerstone Surgical PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

CORNERSTONE SURGICAL PA

Practice address

206 Gamble Drive
Suite C
Lincolnton, NC 28092

Phone

(704) 735-7069

Fax

(704) 735-7537

NPI assigned

Jul 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Keith R Bucklen, MD PANPI 1093877292

Title

President Owner

Phone

(704) 735-7069

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith R Bucklen, M.D.

  • Family Medicine Physician
  • Miramar, FL
  • NPI 1093877292

  Surgery

  NPD Authorized official

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316971237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "28093",
            "telephone_number": "704-735-7069",
            "fax_number": "704-735-7537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 GAMBLE DRIVE",
            "address_2": "SUITE C",
            "city": "LINCOLNTON",
            "state": "NC",
            "postal_code": "28092",
            "telephone_number": "704-735-7069",
            "fax_number": "704-735-7537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE SURGICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUCKLEN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "704-735-7069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PA"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901768",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Donald Lee Copeland Sr., M.D.
• Alison Green Cornwell, M.S., OTR/L
• Gary Dean Cornwell, PHARMACIST
• Rhonda Sherwood Cornwell, MPT
• Counsel for Hope PC
• Michael L Crabill

• All providers in Lincolnton, NC
• Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.