Provider Demographics
NPI:1770051344
Name:DEBORAH BUZZARD, INC.
Entity type:Organization
Organization Name:DEBORAH BUZZARD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BUZZARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-426-6089
Mailing Address - Street 1:2415 LIME KILN LN STE E
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-3429
Mailing Address - Country:US
Mailing Address - Phone:502-426-6089
Mailing Address - Fax:502-339-0312
Practice Address - Street 1:2415 LIME KILN LN STE E
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-3429
Practice Address - Country:US
Practice Address - Phone:502-426-6089
Practice Address - Fax:502-339-0312
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEBORAH BUZZARD, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment