Healthcare Provider Details

I. General information

NPI: 1306079694
Provider Name (Legal Business Name): ERNEST RICHARD KAUFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 W TURNEY AVE
PHOENIX AZ
85013-2832
US

IV. Provider business mailing address

929 W TURNEY AVE
PHOENIX AZ
85013-2832
US

V. Phone/Fax

Practice location:
  • Phone: 602-265-0441
  • Fax: 602-265-0441
Mailing address:
  • Phone: 602-265-0441
  • Fax: 602-265-0441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6329
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: