| Colin Thomas Buckley, | |
|
188 Hospital Dr Ste 205, Fairhope, AL 36532-2038 | |
| (251) 990-9191 | |
| (251) 990-9189 |
| Full Name | Colin Thomas Buckley |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 7 Years |
| Location | 188 Hospital Dr Ste 205, Fairhope, Alabama |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669978359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MD.39153 (Alabama) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Thomas Hospital | Fairhope, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Imc-cancer Surgery Of Mobile, Llc | 1557550589 | 22 |
| Entity Name | Imc-cancer Surgery Of Mobile, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063714012 PECOS PAC ID: 1557550589 Enrollment ID: O20110106000691 |
| Mailing Address | Practice Location Address |
|---|---|
| Colin Thomas Buckley, 3 Mobile Infirmary Cir Ste 305, Mobile, AL 36607-3515 Ph: (251) 990-9191 | Colin Thomas Buckley, 188 Hospital Dr Ste 205, Fairhope, AL 36532-2038 Ph: (251) 990-9191 |
James Richard Koehler, MD DDS Surgery Medicare: Not Enrolled in Medicare Practice Location: 7541 Cipriano Ct, Fairhope, Fairhope, AL 36532 Phone: 251-929-7850 Fax: 251-929-2500 | |
Dr. Jimmie G Gavras, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 188 Hospital Dr Ste 205, Fairhope, AL 36532 Phone: 251-990-9191 Fax: 251-990-9189 | |
Stephen Roy Parden, MD Surgery Medicare: Medicare Enrolled Practice Location: 119 High Pines Rdg, Fairhope, AL 36532 Phone: 251-751-1461 |