Provider Demographics
NPI:1184763229
Name:BUECHELE, JAMES W (PHD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:BUECHELE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2164 PARIS CV
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-1609
Mailing Address - Country:US
Mailing Address - Phone:901-219-3075
Mailing Address - Fax:901-527-1326
Practice Address - Street 1:2164 PARIS CV
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632-1609
Practice Address - Country:US
Practice Address - Phone:901-219-3075
Practice Address - Fax:901-527-1326
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS30447103T00000X, 103TB0200X
TN1381103TB0200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00119063Medicaid
MS302I681209Medicare PIN