MEDICARE: MICHAEL L BUCHANAN SR.

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	183500000X	Pharmacist	19733	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4521527	OTHER		NCPD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922160084
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL L BUCHANAN SR.

Provider Business Mailing Address
First Line	:	PO BOX 96
Second Line	:
City	:	HALLSVILLE
State	:	TX
Zip	:	75650-0096
Country	:	US
Telephone Number	:	903-660-2012
Fax Number	:	903-668-2015

Provider Business Practice Location Address
First Line	:	100 E MAIN STREET
Second Line	:
City	:	HALLSVILLE
State	:	TX
Zip	:	75650-0096
Country	:	US
Telephone Number	:	903-660-2012
Fax Number	:	903-668-2015

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

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	07/08/2007

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