Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. WILLIAM EDWARD BUCKETT, PHYSICIAN ASSISTANT
ActiveMedical Physician Assistant · CENTRALIA, IL
Registration Details
- NPI Number
- 1851481824
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 13, 2006 (19.522884251556 yrs)
- Last Updated
- Nov 12, 2015
- License
-
009118 (NY)
Practice Information
- Address
-
1054 MARTIN LUTHER KING DRSTE 124CENTRALIA, IL, 628013000Browse IL providers · Browse ZIP 62801
- Phone
- 6185338700
- Fax
- 6185338701
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.