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General NPI Number Information
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NPI Number | 1053466789
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Entity Type | Organization
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Legal Business Name | KENNETH BUCHI MD A P C
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 09/26/2007
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Provider Practice Location Address
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Address Line | 3584 WEST 9000 SOUTH SUITE 300
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City | WEST JORDAN
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State | UT
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Zip | 84088-5711
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Country | US
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Telephone | 801-233-8233
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Fax | 801-254-8620
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Provider Business Mailing Address
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Address Line | 3584 WEST 9000 SOUTH SUITE 300
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City | WEST JORDAN
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State | UT
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Zip | 84088-5711
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Country | US
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Telephone | 801-233-8233
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Fax | 801-254-8620
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KENNETH N BUCHI
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Credential | MD
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Telephone | 801-254-8620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 163976-1205
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License Number State | UT
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