Provider Demographics
NPI:1083622682
Name:BUCHANAN, FRANK RANDALL (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:RANDALL
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 WILLAGILLESPIE RD STE 300B
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2172
Mailing Address - Country:US
Mailing Address - Phone:541-484-0244
Mailing Address - Fax:541-485-7881
Practice Address - Street 1:995 WILLAGILLESPIE RD STE 300B
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2172
Practice Address - Country:US
Practice Address - Phone:541-484-0244
Practice Address - Fax:541-485-7881
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10534174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0004266362OtherAETNA
OR2078OtherSAIF
OR058669Medicaid
OR058669Medicaid
ORR133544Medicare PIN