Provider Demographics
NPI:1558543595
Name:BUCHANAN, GORDON FRANK (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:FRANK
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Mailing Address - Street 1:15 YORK ST
Mailing Address - Street 2:LCI-916
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510
Mailing Address - Country:US
Mailing Address - Phone:203-785-4085
Mailing Address - Fax:203-785-6246
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:T-209
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2259
Practice Address - Fax:203-688-5599
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-01
Last Update Date:2023-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0465922084N0400X
IAMD-421172084N0400X, 2084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology