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General NPI Number Information
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NPI Number | 1558355586
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Entity Type | Individual
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Provider Name | JOHN A BUIE MD
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Gender | Male
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 10/19/2023
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Provider Practice Location Address
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Address Line | 213 N ILLINOIS ST
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City | WEATHERFORD
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State | OK
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Zip | 73096-5437
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Country | US
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Telephone | 580-774-5089
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Fax | 580-303-9166
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Provider Business Mailing Address
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Address Line | PO BOX 2169
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City | ELK CITY
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State | OK
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Zip | 73648-2169
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Country | US
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Telephone | 580-821-1185
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Fax | 580-303-9166
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 18370
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License Number State | OK
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