Provider Demographics
NPI: | 1134122583 |
---|---|
Name: | BUFFINGTON, COLLEEN MURPHY (DO) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | COLLEEN |
Middle Name: | MURPHY |
Last Name: | BUFFINGTON |
Suffix: | |
Gender: | F |
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: | 629D LOWTHER RD |
Mailing Address - Street 2: | |
Mailing Address - City: | LEWISBERRY |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 17339-9527 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 717-394-6028 |
Mailing Address - Fax: | 717-394-9223 |
Practice Address - Street 1: | 555 N DUKE ST |
Practice Address - Street 2: | |
Practice Address - City: | LANCASTER |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17602-2250 |
Practice Address - Country: | US |
Practice Address - Phone: | 717-394-6028 |
Practice Address - Fax: | 717-394-9223 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-05-31 |
Last Update Date: | 2018-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | OS010343L | 2085R0202X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
PA | P00176461 | Other | RAILROAD MEDICARE |
PA | 231855378 | Other | TAX ID - LANC RADIOLOGY |
PA | P00176461 | Other | RAILROAD MEDICARE |
PA | 231855378 | Other | TAX ID - LANC RADIOLOGY |