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General NPI Number Information
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NPI Number | 1568581155
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Entity Type | Individual
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Provider Name | CHAD RYAN KAUFFMAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 1821 NORTH SHADELAND
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-9998
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Country | US
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Telephone | 317-870-1581
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Fax | 317-870-1583
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Provider Business Mailing Address
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Address Line | 7615 DEAN RD SUITE 281
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-3635
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Country | US
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Telephone | 317-357-8663
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Fax | 317-357-8842
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 34.009017
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License Number State | OH
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