Provider Demographics
NPI:1225158744
Name:BUFFINTON B. BURTIS, M.D.
Entity Type:Organization
Organization Name:BUFFINTON B. BURTIS, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:BEATY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-770-2301
Mailing Address - Street 1:2440 E TUDOR RD
Mailing Address - Street 2:PMB 141
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1185
Mailing Address - Country:US
Mailing Address - Phone:907-261-3650
Mailing Address - Fax:907-261-4810
Practice Address - Street 1:3200 PROVIDENCE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4615
Practice Address - Country:US
Practice Address - Phone:907-261-3650
Practice Address - Fax:907-261-4810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty