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NPI Code Detail

MEDICARE: DR. JEREMY D. BUFFORD M.D.

MEDICARE: DR. JEREMY D. BUFFORD M.D.
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
1207K00000XAllergy & Immunology PhysicianE-6404AR
2207K00000XAllergy & Immunology Physician50185WI
3208000000XPediatrics Physician50185WI

General Provider Information

NPI Number : 1487603247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEREMY D. BUFFORD M.D.
Provider Business Mailing Address
First Line : 202 S PARK ST
Second Line :
City : MADISON
State : WI
Zip : 53715-1507
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6408 COPPS AVE
Second Line :
City : MONONA
State : WI
Zip : 53716-3702
Country : US
Telephone Number : 608-417-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 06/12/2013

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