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NPI Code Detail

MEDICARE: DR. TIMOTHY J BUFFEY DO

MEDICARE: DR. TIMOTHY J BUFFEY DO
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
1207Q00000XFamily Medicine Physician145829AK
2207Q00000XFamily Medicine Physician34007910OH
3207Q00000XFamily Medicine Physician5101012318MI
4207Q00000XFamily Medicine Physician036-121749IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000245783OTHEROHANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
304238OTHEROHPARAMOUNT
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
55715390OTHERILBLUE CROSS/ BLUE SHIELD
6080191223OTHEROHRRMC
717-29002OTHEROHUHC
85993729OTHEROHAETNA

General Provider Information

NPI Number : 1164422663
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY J BUFFEY DO
Provider Business Mailing Address
First Line : 1300 FRANKLIN AVE
Second Line : SUITE 100
City : NORMAL
State : IL
Zip : 61761-3592
Country : US
Telephone Number : 309-268-3761
Fax Number : 309-268-5620
Provider Business Practice Location Address
First Line : 1100 E DIMOND BLVD STE 103
Second Line :
City : ANCHORAGE
State : AK
Zip : 99515-2010
Country : US
Telephone Number : 907-333-2133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 01/15/2024

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Directions to “ DR. TIMOTHY J BUFFEY DO” Practice Location

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