Provider Demographics
NPI:1407887920
Name:BUCHS, SHALON R (PA)
Entity Type:Individual
Prefix:
First Name:SHALON
Middle Name:R
Last Name:BUCHS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SHALON
Other - Middle Name:R
Other - Last Name:CHORDAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:5801 SW 87TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-8578
Mailing Address - Country:US
Mailing Address - Phone:352-598-3376
Mailing Address - Fax:
Practice Address - Street 1:6500 W NEWBERRY RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4309
Practice Address - Country:US
Practice Address - Phone:352-333-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9103438207P00000X
FLPA9103438363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292492700Medicaid
FLP00435910OtherMEDICARE PIN/RAILROAD MED
FLP00435910OtherMEDICARE PIN/RAILROAD MED
FL292492700Medicaid