Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Georgia Jamillah Buckley, PA-C

Individual provider Physician Assistant · NPI 1205862547

Mrs. Georgia Jamillah Buckley, PA-C is a Physician Assistant in Fayetteville, North Carolina. Qualified in 2005, 21 years ago. Accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
21
Licensed in
NC
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1536 Owen Park Ln
Fayetteville, NC 28304-3454
Phone: (910) 307-1576
Fax: (910) 500-3117
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-00442 (NC)

Record details

NPI number1205862547
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 25, 2006
Last updated in NPPESAugust 10, 2023
Certification dateAugust 10, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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