Healthcare Provider Details

I. General information

NPI: 1548332729
Provider Name (Legal Business Name): G. TOM BIUCKIANS, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 GLENWAY AVE STE. 208
CINCINNATI OH
45211-6378
US

IV. Provider business mailing address

PO BOX 635533
CINCINNATI OH
45263-0044
US

V. Phone/Fax

Practice location:
  • Phone: 513-451-7400
  • Fax: 513-451-7888
Mailing address:
  • Phone: 513-891-2813
  • Fax: 513-793-1032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GHADAM TOM BIUCKIANS
Title or Position: OWNER
Credential: MD
Phone: 513-451-7400