Organization
EDMOND AM CLINIC LLC
Active
Other names
Edmond AM Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BILL J BUFFINGTON M.D. (MEDICAL DIRECTOR)
(405) 216-3993
Entity
Organization
Contact information
Practice address
1714 S KELLY AVE, EDMOND, OK 73013-3624
(405) 216-3993
(405) 216-3992
Mailing address
PO BOX 269083, OKLAHOMA CITY, OK 73126-9083
(405) 216-3993
(405) 216-3992
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N/A
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200134140A
—
OK
Enumeration date
04/10/2008
Last updated
10/21/2011
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