Individual
DR. BUFFIE JANE MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
11500 W 119TH ST, OVERLAND PARK, KS 66213-2002
(913) 451-0001
(913) 451-1659
Mailing address
5195 W 199TH ST, STILWELL, KS 66085-9016
(913) 239-8884
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1577
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27308012
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/30/2006
Last updated
11/27/2012
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