Healthcare Provider Details

I. General information

NPI: 1275699902
Provider Name (Legal Business Name): BUXMONT FAMILY MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 04/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 PROGRESS DR SUITE 4
DOYLESTOWN PA
18901-2563
US

IV. Provider business mailing address

101 PROGRESS DR SUITE 4
DOYLESTOWN PA
18901-2563
US

V. Phone/Fax

Practice location:
  • Phone: 215-345-1101
  • Fax: 215-345-1556
Mailing address:
  • Phone: 215-345-1101
  • Fax: 215-345-1556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberMD052087L
License Number StatePA

VIII. Authorized Official

Name: DAVID A YOON
Title or Position: OWNER
Credential: M.D.
Phone: 215-345-1101