Provider Demographics
NPI:1700267515
Name:BUFFEY, KATHRYN (DO)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:BUFFEY
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 1:9202 CAM ISLAND CIR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-8536
Mailing Address - Country:US
Mailing Address - Phone:309-846-8834
Mailing Address - Fax:907-442-7013
Practice Address - Street 1:435 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:KOTZEBUE
Practice Address - State:AK
Practice Address - Zip Code:99752
Practice Address - Country:US
Practice Address - Phone:907-442-7442
Practice Address - Fax:907-442-7013
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.066608207Q00000X
AK145987207Q00000X
ARE-11588207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine