Provider Demographics
NPI:1386743862
Name:BUYS, DAVID DEAN (PA-C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:DEAN
Last Name:BUYS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3067 EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-1273
Mailing Address - Country:US
Mailing Address - Phone:208-522-4600
Mailing Address - Fax:208-552-7521
Practice Address - Street 1:3067 EAGLE DR
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-1273
Practice Address - Country:US
Practice Address - Phone:208-522-4600
Practice Address - Fax:208-552-7521
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2977363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ882945Medicaid
AZS37009Medicare UPIN