Provider Demographics
NPI:1790999845
Name:BUXTON, DANIEL ELLIOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ELLIOTT
Last Name:BUXTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 SOUTHERN BLVD.
Mailing Address - Street 2:KETTERING PATHOLOGY ASSOCIATES
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429
Mailing Address - Country:US
Mailing Address - Phone:937-395-8849
Mailing Address - Fax:937-395-8350
Practice Address - Street 1:3535 SOUTHERN BLVD.
Practice Address - Street 2:KETTERING PATHOLOGY ASSOCIATES
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429
Practice Address - Country:US
Practice Address - Phone:937-395-8849
Practice Address - Fax:937-395-8350
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN14654207ZP0102X
CAA97359207ZP0102X
OH096867207ZP0102X
OH35096867207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3159838Medicaid