Provider Demographics
NPI:1659014595
Name:SELLS, BUFFIE JO
Entity Type:Individual
Prefix:
First Name:BUFFIE
Middle Name:JO
Last Name:SELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101908 US HWY 59
Mailing Address - Street 2:
Mailing Address - City:SALLISAW, OK
Mailing Address - State:OK
Mailing Address - Zip Code:74955
Mailing Address - Country:US
Mailing Address - Phone:918-385-1755
Mailing Address - Fax:
Practice Address - Street 1:716 S 2ND ST # 1014
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-4806
Practice Address - Country:US
Practice Address - Phone:918-696-6212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist