Healthcare Provider Details

I. General information

NPI: 1013989383
Provider Name (Legal Business Name): ANDREW B KAUFMAN M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 04/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 W 119TH ST SUITE 215
OVERLAND PARK KS
66209-3721
US

IV. Provider business mailing address

5701 W 119TH ST SUITE 215
OVERLAND PARK KS
66209-3721
US

V. Phone/Fax

Practice location:
  • Phone: 888-942-2774
  • Fax: 866-807-1897
Mailing address:
  • Phone: 888-942-2774
  • Fax: 866-807-1897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberR4609
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number04-15463
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberR4609
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: