Provider Demographics
NPI:1639300478
Name:HABERSHAM SURGICAL ASSOCIATES P C
Entity Type:Organization
Organization Name:HABERSHAM SURGICAL ASSOCIATES P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:BUCHANAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-886-0628
Mailing Address - Street 1:PO BOX 953
Mailing Address - Street 2:
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-1416
Mailing Address - Country:US
Mailing Address - Phone:706-886-0628
Mailing Address - Fax:706-886-3735
Practice Address - Street 1:1678 FALLS ROAD
Practice Address - Street 2:
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-2411
Practice Address - Country:US
Practice Address - Phone:706-886-0628
Practice Address - Fax:706-886-3735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty