Provider Demographics
NPI:1861482374
Name:BUENDIA, ARSENIO (MD)
Entity Type:Individual
Prefix:DR
First Name:ARSENIO
Middle Name:
Last Name:BUENDIA
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:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:WEWOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74884-1475
Mailing Address - Country:US
Mailing Address - Phone:405-257-7318
Mailing Address - Fax:405-257-2696
Practice Address - Street 1:HWY 56 & 270 JUNCTION
Practice Address - Street 2:
Practice Address - City:WEWOKA
Practice Address - State:OK
Practice Address - Zip Code:74884
Practice Address - Country:US
Practice Address - Phone:405-257-7318
Practice Address - Fax:405-257-2696
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11471207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1111471Medicaid
OK8HE258Medicare ID - Type UnspecifiedMEDICARE
OKD34455Medicare UPIN