MEDICARE: JOHN A BUIE, M.D. P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	T-01674	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	111382	OTHER	KS	BLUE CROSS/BLUE SHEILD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154504421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN A BUIE, M.D. P.C.

Provider Business Mailing Address
First Line	:	1411 W 15TH ST STE 302
Second Line	:
City	:	LIBERAL
State	:	KS
Zip	:	67901-2285
Country	:	US
Telephone Number	:	620-624-4946
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 W 15TH ST STE 302
Second Line	:
City	:	LIBERAL
State	:	KS
Zip	:	67901-2285
Country	:	US
Telephone Number	:	620-624-4946
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN A BUIE
Credential	:	M.D.
Telephone Number	:	620-624-4946

Provider Enumeration Date	:	12/10/2007
Last Update Date	:	04/28/2008

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