Healthcare Provider Details

I. General information

NPI: 1154304574
Provider Name (Legal Business Name): WILLIAM F BUCHNER, JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 10/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 CHAMBLISS AVE NW
CLEVELAND TN
37311-3882
US

IV. Provider business mailing address

2415 CHAMBLISS AVE NW
CLEVELAND TN
37311-3882
US

V. Phone/Fax

Practice location:
  • Phone: 423-559-2800
  • Fax: 423-559-0532
Mailing address:
  • Phone: 423-559-2800
  • Fax: 423-559-0532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD019707
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: