Provider Demographics
NPI:1093014003
Name:BUCHTA, FRANCIS ANTHONY JR (FRANK BUCHTA)
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:ANTHONY
Last Name:BUCHTA
Suffix:JR
Gender:M
Credentials:FRANK BUCHTA
Other - Prefix:
Other - First Name:FRANCIS
Other - Middle Name:ANTHONY
Other - Last Name:BUCHTA
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:FRANK BUCHTA
Mailing Address - Street 1:4784 CHAMPIONS WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-2074
Mailing Address - Country:US
Mailing Address - Phone:706-568-9855
Mailing Address - Fax:706-568-9855
Practice Address - Street 1:4784 CHAMPIONS WAY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909
Practice Address - Country:US
Practice Address - Phone:706-568-9855
Practice Address - Fax:706-568-9855
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH017145183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist