Provider Demographics
NPI:1649524638
Name:COE, BUFORD DEVIN (ABOC,NCLE,BSHCA,MBA)
Entity type:Individual
Prefix:
First Name:BUFORD
Middle Name:DEVIN
Last Name:COE
Suffix:
Gender:M
Credentials:ABOC,NCLE,BSHCA,MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 SOUTH 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39567
Mailing Address - Country:US
Mailing Address - Phone:228-447-1580
Mailing Address - Fax:
Practice Address - Street 1:401 SCHILLINGER RD N
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-5203
Practice Address - Country:US
Practice Address - Phone:255-371-3891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156F00000XEye and Vision Services ProvidersTechnician/Technologist
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
No156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
No156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant
No156FX1201XEye and Vision Services ProvidersTechnician/TechnologistOptometric Assistant
No156FX1202XEye and Vision Services ProvidersTechnician/TechnologistOptometric Technician