Provider Demographics
NPI:1114107836
Name:BUFFIN, TANIESHA L (MD)
Entity Type:Individual
Prefix:DR
First Name:TANIESHA
Middle Name:L
Last Name:BUFFIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2617 S ELM PL
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-7850
Mailing Address - Country:US
Mailing Address - Phone:918-394-2229
Mailing Address - Fax:918-994-4875
Practice Address - Street 1:2617 S ELM PL
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7850
Practice Address - Country:US
Practice Address - Phone:918-394-2229
Practice Address - Fax:918-994-4875
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK27728207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology