Provider Demographics
NPI:1154304574
Name:BUCHNER, JR., WILLIAM F (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:BUCHNER, JR.
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 1:2415 CHAMBLISS AVE NW
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-3882
Mailing Address - Country:US
Mailing Address - Phone:423-559-2800
Mailing Address - Fax:423-559-0532
Practice Address - Street 1:2415 CHAMBLISS AVE NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3882
Practice Address - Country:US
Practice Address - Phone:423-559-2800
Practice Address - Fax:423-559-0532
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD019707207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0092109OtherBLUE CROSS
TNTN0101OtherJOHN DEERE
TN3046168Medicaid
TN5326379OtherAETNA
TN100003835OtherRAILROAD MEDICARE
TNTN0101OtherJOHN DEERE
3046168Medicare PIN