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General NPI Number Information
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NPI Number | 1841008935
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Entity Type | Individual
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Provider Name | TOMMY BUCHANAN
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Gender | Male
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Dates
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Enumeration Date | 12/21/2024
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 400 E STATE ST STE D
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City | ATHENS
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State | OH
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Zip | 45701-1870
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Country | US
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Telephone | 740-326-6110
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Fax |
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Provider Business Mailing Address
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Address Line | 723 PHILLIPS AVE BLDG E
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City | TOLEDO
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State | OH
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Zip | 43612-1351
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Country | US
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Telephone | 419-378-9212
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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