Buckner Prosthetic and Orthotic Laboratories Inc.

Primary specialty

OrthotistTaxonomy code 222Z00000X

Legal business name

BUCKNER PROSTHETIC AND ORTHOTIC LABORATORIES INC.

Practice address

2 Old River PL
Suite D
Jackson, MS 39202-3435

Phone

(601) 944-1130

Fax

(601) 355-7476

NPI assigned

Sep 8, 2005

Last updated

Oct 4, 2013By 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

Mr. Martin L Buckner, C.P.O.

Title

Owner

Phone

(601) 944-1130

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1427042134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OLD RIVER PL",
            "address_2": "SUITE D",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023435",
            "telephone_number": "601-944-1130",
            "fax_number": "601-355-7476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OLD RIVER PL",
            "address_2": "SUITE D",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392023435",
            "telephone_number": "601-944-1130",
            "fax_number": "601-355-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKNER PROSTHETIC AND ORTHOTIC LABORATORIES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-944-1130",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P.O."
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040395",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monique Buckhaulter, LPC
• Kelly Buckholdt, PH.D.
• Mary Hannah Bucklew, NP
• Christen H Buckley, NP-C
• Evan Anthony Buckley, DO
• Anna Michelle Buckner, LPC
• Deyanna Buckner
• Dominique Jaquetta Nicole Buckner
• Ernest W Bueche II, ATC
• Maria Ximena Bueno, M.D.

• Orthotist in Jackson, MS
• Providers in Jackson, MS by specialty
• Orthotist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.