Healthcare Provider Details

I. General information

NPI: 1922206168
Provider Name (Legal Business Name): KEVIN-STEVEN C BUFORD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CANAL STREET
NEW ORLEANS LA
70112-1352
US

IV. Provider business mailing address

1816 INDUSTRIAL BLVD
HARVEY LA
70058-2314
US

V. Phone/Fax

Practice location:
  • Phone: 504-903-3000
  • Fax:
Mailing address:
  • Phone: 504-366-7638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberMD204496
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberMD438968
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberA100796
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number207PE0005X
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: