| Stacie D Buckley, | |
|
1067 Peachtree St, Louisville, GA 30434-1599 | |
| (478) 625-7000 | |
| Not Available |
| Full Name | Stacie D Buckley |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 1067 Peachtree St, Louisville, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265297873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN140629 (Georgia) | Primary |
| Entity Name | Southland Emergency Medical Services Consolidated, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033464391 PECOS PAC ID: 4183871320 Enrollment ID: O20120823000503 |
| Entity Name | Theoria Medical |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609362375 PECOS PAC ID: 5395098339 Enrollment ID: O20230105001168 |
| Mailing Address | Practice Location Address |
|---|---|
| Stacie D Buckley, 1067 Peachtree St, Louisville, GA 30434-1558 Ph: () - | Stacie D Buckley, 1067 Peachtree St, Louisville, GA 30434-1599 Ph: (478) 625-7000 |
James Thomas Hulme, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1067 Peachtree St, Louisville, GA 30434 Phone: 478-625-8333 | |
Mrs. Erin Grace Nobles, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1067 Peachtree St, Louisville, GA 30434 Phone: 478-625-8471 Fax: 478-625-8477 | |
Mrs. Regina G Cody, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1067 Peachtree St, Louisville, GA 30434 Phone: 478-625-7000 Fax: 478-625-8907 | |
Phillip Zachary Perkins, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1067 Peachtree St, Louisville, GA 30434 Phone: 478-625-8471 | |
Mrs. Amy Bedingfield, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1067 Peachtree St, Louisville, GA 30434 Phone: 478-625-7000 Fax: 478-625-8907 |