Tad Willis Buckingham O.D.

NPI 1992876056 - Optometrist - 152W00000X

NPI Details
NPI 1992876056
Gender Male
Enumeration Date 11/12/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
7615 SW SPEAKS DR
GASTON OR, 97119-9117, US
Phone (503) 459-9247
Fax (503) 357-5493
Business Location
7615 SW SPEAKS DR
GASTON OR, 97119-9117, US
Phone (503) 459-9247
Fax (503) 357-5493
Toxanomy
Taxonomy Code 152W00000X
License State Oregon
License Number 4022ATI
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According to our database, Tad Willis Buckingham O.D. NPI is 1992876056, taxonomy code is 152W00000X and license number is 4022ATI, license state is located at Oregon. Tad Willis Buckingham O.D. physically located at 7615 Sw Speaks Dr, Gaston OR, 97119-9117. NPI Number Tad Willis Buckingham O.D. has the Individual type.

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1992876056 NPI number is provided on an as is basis without warranty of any kind. 1992876056 is maintained by the National Plan & Provider Enumeration System. The contents of Tad Willis Buckingham O.D. are for informational purposes only.