Healthcare Provider Details

I. General information

NPI: 1467440974
Provider Name (Legal Business Name): JEFFREY ELWOOD KAUFFMAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 S QUEEN ST
YORK PA
17402-4941
US

IV. Provider business mailing address

2410 S QUEEN ST
YORK PA
17402-4941
US

V. Phone/Fax

Practice location:
  • Phone: 717-718-5511
  • Fax: 717-718-5381
Mailing address:
  • Phone: 717-718-5511
  • Fax: 717-718-5381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC005598
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: