Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0101236252 | VA |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 53860 | TN |
NPI | 1326044298 |
---|---|
Provider Name | Matthew M Buchanan |
First Address | Chattanooga, TN 37404-3322 |
Second Address | Chattanooga, TN 37404-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 08/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H85400 | (02) | CO |