Provider Demographics
NPI:1548332729
Name:G. TOM BIUCKIANS, M.D.
Entity type:Organization
Organization Name:G. TOM BIUCKIANS, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GHADAM
Authorized Official - Middle Name:TOM
Authorized Official - Last Name:BIUCKIANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-451-7400
Mailing Address - Street 1:PO BOX 635533
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0044
Mailing Address - Country:US
Mailing Address - Phone:513-891-2813
Mailing Address - Fax:513-793-1032
Practice Address - Street 1:6350 GLENWAY AVE
Practice Address - Street 2:STE. 208
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-6378
Practice Address - Country:US
Practice Address - Phone:513-451-7400
Practice Address - Fax:513-451-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A36486Medicare UPIN