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General NPI Number Information
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NPI Number | 1164482725
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Entity Type | Individual
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Provider Name | DAVID A KAUFMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 07/08/2024
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Provider Practice Location Address
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Address Line | 463 ASHLEY RIDGE BLVD STE 100
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City | SHREVEPORT
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State | LA
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Zip | 71106-7231
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Country | US
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Telephone | 318-221-3584
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Fax | 318-227-9094
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Provider Business Mailing Address
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Address Line | 1541 KINGS HWY ATTN: PAYOR CREDENTIALING
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City | SHREVEPORT
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State | LA
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Zip | 71103-4228
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Country | US
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Telephone | 318-626-0287
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | MD14915
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD14915
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License Number State | LA
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