Healthcare Provider Details

I. General information

NPI: 1477510535
Provider Name (Legal Business Name): HENRY JOSEPH KAUFMAN III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N LEWIS ST
NEW IBERIA LA
70563-2043
US

IV. Provider business mailing address

4724 WHITEHAVEN ST
BATON ROUGE LA
70808-3878
US

V. Phone/Fax

Practice location:
  • Phone: 800-893-9698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number011444
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number011444
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: