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NPI Code Detail

MEDICARE: DR. JOHN ROBERT BUCHOLTZ DO

MEDICARE: DR. JOHN ROBERT BUCHOLTZ DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician025116GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861411746
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN ROBERT BUCHOLTZ DO
Provider Business Mailing Address
First Line : PO BOX 1038
Second Line :
City : COLUMBUS
State : GA
Zip : 31902-1038
Country : US
Telephone Number : 706-571-1120
Fax Number :
Provider Business Practice Location Address
First Line : 1800 10TH AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-1513
Country : US
Telephone Number : 706-571-1120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 08/29/2012

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Directions to “ DR. JOHN ROBERT BUCHOLTZ DO” Practice Location

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