Provider Demographics
NPI:1720023344
Name:BUECHLER, THOMAS G (OD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:G
Last Name:BUECHLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-3125
Mailing Address - Country:US
Mailing Address - Phone:812-482-2195
Mailing Address - Fax:812-634-6620
Practice Address - Street 1:501 CLAY ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3125
Practice Address - Country:US
Practice Address - Phone:812-482-2195
Practice Address - Fax:812-634-6620
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002186B152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN660680Medicare PIN
INU29797Medicare UPIN