MEDICARE: WILLIAM L BUCHANAN M.D., D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	F5162	TX
2	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	9189	TX

General Provider Information

NPI Number	:	1023185261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM L BUCHANAN M.D., D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 979
Second Line	:
City	:	TAYLOR
State	:	TX
Zip	:	76574-0979
Country	:	US
Telephone Number	:	512-346-8830
Fax Number	:	512-472-5713

Provider Business Practice Location Address
First Line	:	6012 W WILLIAM CANNON DR
Second Line	:	B101
City	:	AUSTIN
State	:	TX
Zip	:	78749-1980
Country	:	US
Telephone Number	:	512-346-8830
Fax Number	:	512-472-5713

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	04/14/2016

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Directions to “ WILLIAM L BUCHANAN M.D., D.D.S.” Practice Location

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