Provider Demographics
NPI:1922262450
Name:BUISKER, ELIZABETH A (DO)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:BUISKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-2001
Mailing Address - Country:US
Mailing Address - Phone:970-298-1782
Mailing Address - Fax:970-298-1726
Practice Address - Street 1:2333 N 6TH ST
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-2001
Practice Address - Country:US
Practice Address - Phone:970-298-1782
Practice Address - Fax:970-298-1726
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO55588514Medicaid
CO55588514Medicaid
COCO307218Medicare PIN