Provider Demographics
NPI:1538153895
Name:BUCHAN, THOMAS CHRISTOPHER (CRNA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:CHRISTOPHER
Last Name:BUCHAN
Suffix:
Gender:M
Credentials:CRNA
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 1380
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-1307
Mailing Address - Country:US
Mailing Address - Phone:706-571-1374
Mailing Address - Fax:706-660-2686
Practice Address - Street 1:710 CENTER ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1527
Practice Address - Country:US
Practice Address - Phone:706-571-1374
Practice Address - Fax:706-660-2686
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN134961367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA43ZCBXV17Medicare ID - Type Unspecified
GAQ22909Medicare UPIN