Provider Demographics
NPI:1699227918
Name:AMELIA L. BUECHE, D.O., LLC
Entity Type:Organization
Organization Name:AMELIA L. BUECHE, D.O., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMELIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:BUECHE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:541-482-0342
Mailing Address - Street 1:850 SISKIYOU BLVD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2125
Mailing Address - Country:US
Mailing Address - Phone:541-482-0342
Mailing Address - Fax:541-482-6986
Practice Address - Street 1:850 SISKIYOU BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2125
Practice Address - Country:US
Practice Address - Phone:541-482-0342
Practice Address - Fax:541-482-6986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO172158261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center