Provider Demographics
NPI:1477434470
Name:BUCHANAN, ANTHONY JAMES
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JAMES
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4306
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72214-4306
Mailing Address - Country:US
Mailing Address - Phone:501-837-2035
Mailing Address - Fax:501-500-6355
Practice Address - Street 1:419 BOBWHITE DR APT 143
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5176
Practice Address - Country:US
Practice Address - Phone:501-837-2035
Practice Address - Fax:501-500-6355
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225C00000X
AR261QA0600X, 373H00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist