Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35041 | IA |
N | 207X00000X | Orthopaedic Surgeon | 42906 | KY |
Y | 207X00000X | Orthopaedic Surgeon | E-10082 | AR |
NPI | 1013900562 |
---|---|
Provider Name | Dr. Mark Edward Buchanan |
First Address | Russellville, AR 72801-3363 |
Second Address | Russellville, AR 72801-3363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 17/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000620840 | ANTHEM (01) | KY |
7100089980 | (05) | KY |
H47261 | (02) | IA |
P00752415 | RAILROAD (01) | KY |