Healthcare Provider Details

I. General information

NPI: 1922146760
Provider Name (Legal Business Name): KURT A BUECHLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 12/17/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 HIGHLAND COLONY PARKWAY SUITE 101
RIDGELAND MS
39157
US

IV. Provider business mailing address

625 HIGHLAND COLONY PARKWAY SUITE 101
RIDGELAND MS
39157
US

V. Phone/Fax

Practice location:
  • Phone: 601-853-2676
  • Fax: 601-853-9535
Mailing address:
  • Phone: 601-853-2676
  • Fax: 601-853-9535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number13984
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number13984
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: