Individual
DR. JUSTIN TODD BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1924 ALCOA HWY # U107, KNOXVILLE, TN 37920-1511
(865) 305-9661
(865) 305-6148
Mailing address
527 N PALO ALTO AVE, PANAMA CITY, FL 32401-3639
(850) 747-4905
(850) 747-4907
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2018-03007
NC
2085R0202X
Diagnostic Radiology Physician
Primary
46689
TN
2085R0202X
Diagnostic Radiology Physician
ME126787
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016743700
—
FL
01
—
IM424X
MEDICARE PTAN
FL
01
—
IM424Y
MEDICARE PTAN
FL
01
—
IM424Z
MEDICARE PTAN
FL
01
—
KZBPL
BCBS
FL
01
—
P01664307
RAILROAD MEDICARE
FL
Enumeration date
07/02/2009
Last updated
08/21/2019
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