Provider Demographics
NPI:1669676268
Name:BUYTEN, JEFFREY ALFON (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALFON
Last Name:BUYTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3033 NW 63RD ST STE 152E
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-3607
Mailing Address - Country:US
Mailing Address - Phone:405-755-6651
Mailing Address - Fax:405-755-2313
Practice Address - Street 1:3650 W ROCK CREEK RD
Practice Address - Street 2:110A
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2202
Practice Address - Country:US
Practice Address - Phone:405-364-2666
Practice Address - Fax:405-364-9627
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26178207Y00000X
TXBP2-0016825207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200202110 AMedicaid
OK200202110 AMedicaid
689881712OtherMYUTMB 689881712-COMMERCIAL NUMBER