Healthcare Provider Details

I. General information

NPI: 1619947785
Provider Name (Legal Business Name): JULIAN P KUFFLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 COMMUNITY LN
SOUTHWEST HARBOR ME
04679-4273
US

IV. Provider business mailing address

10 WAYMAN LN
BAR HARBOR ME
04609-1625
US

V. Phone/Fax

Practice location:
  • Phone: 207-244-5630
  • Fax: 207-244-4418
Mailing address:
  • Phone: 207-288-5081
  • Fax: 207-288-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number011321
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: