Provider Demographics
NPI:1104357862
Name:BUFORD, THOMAS D (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:D
Last Name:BUFORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 722354
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-8783
Mailing Address - Country:US
Mailing Address - Phone:903-571-3844
Mailing Address - Fax:855-343-5763
Practice Address - Street 1:120 STONE CREEK BLVD STE 500
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8210
Practice Address - Country:US
Practice Address - Phone:601-420-2040
Practice Address - Fax:601-420-2356
Is Sole Proprietor?:No
Enumeration Date:2017-03-24
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS28774207L00000X, 207LP2900X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program