| Alice Buckley, MD | |
|
3728 S Reed Rd, Kokomo, IN 46902-3829 | |
| (765) 626-7110 | |
| Not Available |
| Full Name | Alice Buckley |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine - Addiction Medicine |
| Location | 3728 S Reed Rd, Kokomo, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659359891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0401X | Internal Medicine - Addiction Medicine | 01080469A (Indiana) | Primary |
| 207RA0401X | Internal Medicine - Addiction Medicine | E4648 (Arkansas) | Secondary |
| Entity Name | Cleanslate Medical Group of Indiana LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023464294 PECOS PAC ID: 4880963909 Enrollment ID: O20171023001515 |
| Mailing Address | Practice Location Address |
|---|---|
| Alice Buckley, MD 1513 Ironwood Dr, Marion, IN 46952-1564 Ph: Not Available | Alice Buckley, MD 3728 S Reed Rd, Kokomo, IN 46902-3829 Ph: (765) 626-7110 |
Leny Philip, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 3118 S Lafountain St, Kokomo, IN 46902 Phone: 765-864-4160 Fax: 765-864-4166 |
Huan Cui, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1907 W Sycamore St, Kokomo, IN 46901 Phone: 765-456-5433 |
Dr. Dawn Marie Sabau, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3508 S Lafountain St, Kokomo, IN 46902 Phone: 765-453-8181 Fax: 765-453-8565 |
Julie B Tredemeyer, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3505 S Reed Rd, Kokomo, IN 46902 Phone: 765-776-5500 |
Karthik Rao Polsani, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3500 S Lafountain St, Kokomo, IN 46902 Phone: 765-776-3020 Fax: 775-453-8111 |
Muni K Theertham, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3500 S Lafountain St, Kokomo, IN 46902 Phone: 765-776-3020 Fax: 765-453-8111 |
Philippe B Delalande, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2330 S Dixon Rd, Kokomo, IN 46902 Phone: 765-455-5400 |