Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Tavis Scott Buckingham, IDC

Individual provider Independent Duty Corpsman · NPI 1659587871

Mr. Tavis Scott Buckingham, IDC is an Independent Duty Corpsman in San Diego, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2007
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Practice location Address checks out

Uss New Orleans (lpd 18) Fpo Ap 96673-1701 Commanding Officer
San Diego, CA 92123
Phone: (619) 849-1480
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Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X (CA)

Record details

NPI number1659587871
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorYes
NPI enumeratedMay 15, 2007
Last updated in NPPESJuly 8, 2007

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