Provider Demographics
NPI:1710162227
Name:BUCHANAN, THOMAS MAURICE (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MAURICE
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:175 N 100 W
Mailing Address - Street 2:SUITE N104
Mailing Address - City:VERNAL
Mailing Address - State:UT
Mailing Address - Zip Code:84078-2049
Mailing Address - Country:US
Mailing Address - Phone:435-781-8464
Mailing Address - Fax:435-781-8466
Practice Address - Street 1:30 N 1900 E
Practice Address - Street 2:#3R210
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0002
Practice Address - Country:US
Practice Address - Phone:801-585-6387
Practice Address - Fax:801-581-4192
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2015-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT680514112052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology