| Doctor Name: | DR. ERIC RAYMOND BUCKLEY |
| NPI Number: | 1215171137 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DOM |
| License Number: | 993 |
| Business Practice Address: | 455 Saint Michaels Dr Santa Fe, NM - 875057601 |
| Business Phone Number: | 5059135392 |
| Business Fax Number: | 5059896021 |
| Mailing Address: | 455 Saint Michaels Dr, Physician Practices, Attn: Carla Gomez SANTA FE |
| State: | NM |
| Postal Code: | 875057601 |
| Phone Number: | 5058205227 |
| Fax Number: | |
| NPI Enumeration Date: | 04/22/2009 |
| NPI Last Update Date: | 11/05/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 993 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |