Healthcare Provider Details

I. General information

NPI: 1124032362
Provider Name (Legal Business Name): LUKE BARNES KAUFFMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1656 MALVERN AVE SUITE A
HOT SPRINGS AR
71901-7138
US

IV. Provider business mailing address

1656 MALVERN AVE SUITE A
HOT SPRINGS AR
71901-7138
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-1179
  • Fax: 501-624-4109
Mailing address:
  • Phone: 501-624-1179
  • Fax: 501-624-4109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number297013
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: