Doctor Name: | LAWRENCE EDWARD BUCKMAN |
NPI Number: | 1093938359 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | C PED. |
License Number: | |
Business Practice Address: | 5823 E Riverside Blvd Rockford, IL - 611144963 |
Business Phone Number: | 8156541900 |
Business Fax Number: | 8152829567 |
Mailing Address: | 5823 E Riverside Blvd, ROCKFORD |
State: | IL |
Postal Code: | 611144963 |
Phone Number: | 8156541900 |
Fax Number: | 8152829567 |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |