Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 7361 | KY |
NPI | 1013293794 |
---|---|
Provider Name | Dr. Michael P Buchart JR. |
First Address | Lexington, KY 40517-4141 |
Second Address | Lexington, KY 40517-4141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2011 |
Last Update Date | 26/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
60001096 | (05) | KY |