Provider Demographics
NPI:1336308733
Name:BUCHANAN, JEFFREY DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DAVID
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3850 WINDERMERE PKWY
Mailing Address - Street 2:STE 105
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041
Mailing Address - Country:US
Mailing Address - Phone:678-455-2800
Mailing Address - Fax:770-888-9998
Practice Address - Street 1:3850 WINDERMERE PKWY
Practice Address - Street 2:STE 105
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041
Practice Address - Country:US
Practice Address - Phone:678-455-2800
Practice Address - Fax:770-888-9998
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA003239363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant