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NPI Code Detail

MEDICARE: MALCOLM L. BUFORD JR. MD

MEDICARE: MALCOLM L. BUFORD JR. MD
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
1207RN0300XNephrology Physician27926OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164424990
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALCOLM L. BUFORD JR. MD
Provider Business Mailing Address
First Line : PO BOX 268838
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73126-8838
Country : US
Telephone Number : 918-619-4400
Fax Number : 918-619-4591
Provider Business Practice Location Address
First Line : 591 E 36TH ST N
Second Line :
City : TULSA
State : OK
Zip : 74106-1812
Country : US
Telephone Number : 918-619-4888
Fax Number : 918-619-4591
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 03/24/2016

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Directions to “ MALCOLM L. BUFORD JR. MD” Practice Location

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