Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DS022498-L | PA |
Y | 213EG0000X | General Practice | DS022498-L | PA |
NPI | 1003819756 |
---|---|
Provider Name | Dr. Judy Lynn Buxton |
First Address | Villanova, PA 19085-1706 |
Second Address | Bryn Mawr, PA 19010-2133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 08/07/2007 |