Provider Demographics
NPI:1902914500
Name:BUFFKIN, MICHELE A (PT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:A
Last Name:BUFFKIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8560 OAK COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:KS
Mailing Address - Zip Code:66018-8397
Mailing Address - Country:US
Mailing Address - Phone:816-590-6898
Mailing Address - Fax:
Practice Address - Street 1:2905 SW 29TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-2003
Practice Address - Country:US
Practice Address - Phone:785-271-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1101358174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSPENDINGMedicare ID - Type UnspecifiedPENDINT