Healthcare Provider Details

I. General information

NPI: 1578875456
Provider Name (Legal Business Name): JOANNA CHANDRA SALMON KAUFFMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNA CHANDRA SALMON MD

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 10/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N MAIN ST
BLUFFTON OH
45817-1284
US

IV. Provider business mailing address

PO BOX 636930
CINCINNATI OH
45263-6930
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-5002
  • Fax: 419-996-5001
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0116022974
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.123229
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: