Organization Name: | BUFFALO COUNTRY MEDICAL, P.C. |
NPI Number: | 1437533528 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SARAH TYSZKO (PARTNER) |
Mailing Address: | 1308 E Carl Albert Pkwy # A Mcalester |
State: | OK US |
Postal Code: | 745015130 |
Phone Number: | 4697665203 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2015 |
NPI Last Update Date: | 07/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |