Philip D Buckley, MD
Individual provider Active NPI Internal Medicine Physician · Moses Lake, WA
NPI 1720014947 · NPPES record last updated Sep 17, 2020
Key facts
- NPI
- 1720014947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD00030847WA (WA)
- Practice address
- 840 E Hill Ave
Moses Lake, WA 98837-2238 - Phone
- (509) 663-8711
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00030847WA | WA | MD | Internal Medicine Physician |
Interoperability endpoints
- pbuckley80439@edirect.chehr.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD00030847WA | WA | Yes |
Addresses
Primary practice location
840 E Hill Ave
Moses Lake, WA 98837-2238
Mailing address
820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 055967 | Medicaid | OR |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ |
Other providers in Moses Lake, WA
- Sharon Browne
- Elise Nicole Bruce
- Jacob Francis Bruce
- Joshua Lawrence Bruce
- Randy Clair Bruce
- Natalie Buckman
- Danika Marie Burton
- Sierra Butler
- Rebecca L Byers
- Dino A Cacchiotti
All providers in Moses Lake, WA · Internal Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 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.