Provider Demographics
NPI:1144275744
Name:BUCHELE PLASTIC SURGERY, P.C.
Entity type:Organization
Organization Name:BUCHELE PLASTIC SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENTLEY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BUCHELE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-758-6888
Mailing Address - Street 1:40 FOUR MILE DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2655
Mailing Address - Country:US
Mailing Address - Phone:406-758-6888
Mailing Address - Fax:406-758-0104
Practice Address - Street 1:40 FOUR MILE DR
Practice Address - Street 2:SUITE 5
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2655
Practice Address - Country:US
Practice Address - Phone:406-758-6888
Practice Address - Fax:406-758-0104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT110562086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty