Dr. Willard Bruce Bucklew
Urology

Address: 151 Jefferson Davis Blvd, Suite H, Natchez, MS 39120
Phone: 6014423232

Dr. Willard Bruce Bucklew (NPI# 1922117753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1922117753
Entity Type Individual
Full Name Dr. Willard Bruce Bucklew
Credential MD
Gender Male
Practice Address 151 Jefferson Davis Blvd
Suite H
Natchez
MS 39120
Practice Telephone 6014423232
Practice Fax Number 6014426050
Mailing Address 151 Jefferson Davis Blvd
Suite H
Natchez
MS 39120
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2006-08-29
Last Update Date 2007-07-09

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 208800000X Urology Allopathic & Osteopathic Physicians 17300 MS

Other Provider Identifier

State Identifier Issuer Type Code
LA 1109045 MEDICAID
P00073012 OTHER MEDICARE RAILROAD
MS 00124459 MEDICAID

Physician Overview

NPI 1922117753
PAC ID by PECOS 3072505924
Professional Enrollment ID I20091012000328
Full Name Willard B Bucklew
Organization Legal Name W. BRUCE BUCKLEW, MD, PLLC
Phone Number 9284021168
Gender M
Credential MD
Medical School UNIVERSITY OF SOUTHERN CALIFORNIA SCHOOL OF MEDICINE
Graduation Year 1961
Primary Specialty UROLOGY
Group Practice PAC ID 2365626439
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
031314 COBRE VALLEY REGIONAL MEDICAL CENTER

Office Location

Street Address 151 JEFFERSON DAVIS BLVD
SUITE H
City NATCHEZ
State MS
Zip Code 39120

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720014939 Leslie E England Specialist 151 Jefferson Davis Blvd, Suite C, Natchez, MS 39120-5140 2006-06-23
1659647972 Natchez Hma Physician Management, LLC Family Medicine 151 Jefferson Davis Blvd, Suite H, Natchez, MS 39120-5140 2012-03-30
1811180623 Taylor and Ball Orthopedic Clinic Pa Orthopaedic Surgery 151 Jefferson Davis Blvd, Suite C, Natchez, MS 39120-5140 2007-08-24

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518439041 Compassionate Hearts Personal Care and Respite Services, LLC In Home Supportive Care 642 Us-61, Natchez, MS 39120 2018-12-21
1164918728 We Care Express LLC Non-emergency Medical Transport (VAN) 137 Greystone Pl, Natchez, MS 39120 2018-07-06
1053841585 Tyler Lee Huls Specialist/Technologist 48 Sgt Prentiss Drive, Natchez, MS 39120 2017-06-18
1760818017 Miss-lou Dental LLC Dentist 110 Highway 61 South, Natchez, MS 39120 2013-09-18
1922344902 Bluebonnet Dental Care Natchez Dentist 101 Highway 61 South, Natchez, MS 39120 2012-12-20
1265781033 Hal Sheldon Edwards Pharmacist 285 Sgt Prentiss Drive, Natchez, MS 39120 2012-09-07
1598056046 Air Evac Ems Inc Ambulance 10 Roux 61 Drive, Natchez, MS 39120 2011-05-02
1306165717 Natchez Medical Foundation Inc. Internal Medicine 46 Sgt. S. Prentiss Drive, Suite 201, Natchez, MS 39120 2010-05-25
1447577184 Brennan Thomas O'brien I Student in an Organized Health Care Education/Training Program 317 Highland Blvd Ste C, Natchez, MS 39120 2010-04-20
1003089954 Jay H. Schwartz, M.d., P.a. Surgery 131 Jefferson Davis Blvd Suite B, Suite B, Natchez, MS 39120 2008-04-10
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Taxonomy Information

Taxonomy Code 208800000X
Grouping Allopathic & Osteopathic Physicians
Classification Urology

Taxonomy Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1881006807 Roy Donald Duncan Urology 300 Forrest Hill Cir, Aberdeen, MS 39730-2147 2014-05-26
1396184149 Robert Joseph Hargis Urology 116 Afton Way, Clinton, MS 39056 2013-06-14
1619290400 Woodie Lynn Mason Urology 115 Wildwood Dr, Madison, MS 39110-7045 2010-03-08
1639305592 William Meredith Brodford Urology 3916 Pinewood, Dr., Jackson, MS 39211-6444 2009-06-05
1932233392 Jens Francis Graversen Urology 306 S 12th Ave, Laurel, MS 39440-4327 2007-03-15
1548327273 Oxford Urology Associates, Pllc Urology 2168 S Lamar Blvd, Oxford, MS 38655-5224 2007-01-02
1073682035 Doyle Land Renfroe Urology 1201 Medical Park Dr, Oxford, MS 38655-5327 2006-11-06
1629159587 Urological Surgery Associates Pllc Urology 294 E Layfair Dr, Flowood, MS 39232-9526 2006-10-18
1013098995 Avinash C Gulanikar Urology 294 East Layfair Dr, Flowood, MS 39232 2006-10-18
1912088295 Urology Clinic of Meridian, P.a. Urology 1302 20th Ave, Meridian, MS 39301-4120 2006-10-17
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Competitor

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City NATCHEZ
Zip Code 39120

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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