Provider Demographics
NPI:1063410488
Name:BUXTON, MATTHEW G (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:G
Last Name:BUXTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3511 CLINTON PL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-2196
Mailing Address - Country:US
Mailing Address - Phone:785-749-7546
Mailing Address - Fax:785-749-4560
Practice Address - Street 1:3511 CLINTON PL
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2196
Practice Address - Country:US
Practice Address - Phone:785-749-7546
Practice Address - Fax:785-749-4560
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0426254207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F93768Medicare UPIN