Provider Demographics
NPI:1346395043
Name:ROBERT BUCHALTER M.D. AND ASSOC
Entity Type:Organization
Organization Name:ROBERT BUCHALTER M.D. AND ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCHALTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-767-0500
Mailing Address - Street 1:6005 PARK AVE STE 524B
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5215
Mailing Address - Country:US
Mailing Address - Phone:901-767-0500
Mailing Address - Fax:901-682-3536
Practice Address - Street 1:6005 PARK AVE STE 524B
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5215
Practice Address - Country:US
Practice Address - Phone:901-767-0500
Practice Address - Fax:901-682-3536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN050762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN337234Medicaid
TN337234Medicaid
TNB03467Medicare UPIN