| Doctor Name: | RUSSELL BUFORD |
| NPI Number: | 1144687682 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCAS |
| License Number: | 22220 |
| Business Practice Address: | 131 Walnut St Waynesville, NC - 287863250 |
| Business Phone Number: | 8286313973 |
| Business Fax Number: | 8286319280 |
| Mailing Address: | Po Box 2187, SYLVA |
| State: | NC |
| Postal Code: | 287792187 |
| Phone Number: | 8286313973 |
| Fax Number: | 8286319280 |
| NPI Enumeration Date: | 01/27/2016 |
| NPI Last Update Date: | 01/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 22220 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |