Provider Demographics
NPI:1932780897
Name:BUCHANAN, HUGHIE GEORGE
Entity Type:Individual
Prefix:
First Name:HUGHIE
Middle Name:GEORGE
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5522 BARNSTEAD CIR STE 3
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6617
Mailing Address - Country:US
Mailing Address - Phone:754-235-8955
Mailing Address - Fax:
Practice Address - Street 1:5522 BARNSTEAD CIR STE 3
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6617
Practice Address - Country:US
Practice Address - Phone:754-235-8955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL572468207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services