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General NPI Number Information
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NPI Number | 1679603385
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Entity Type | Organization
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Legal Business Name | JOHN E GIBSON, M.D., JOSEPH H. KAUFMAN, M.D.,LTD
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 5249 DUKE ST STE 5
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City | ALEXANDRIA
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State | VA
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Zip | 22304-2907
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Country | US
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Telephone | 703-751-2616
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Fax | 703-370-8275
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Provider Business Mailing Address
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Address Line | 5249 DUKE ST STE 5
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City | ALEXANDRIA
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State | VA
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Zip | 22304-2907
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Country | US
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Telephone | 703-751-2616
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Fax | 703-370-8275
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | KRISTOPHER JON KAUFMAN
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Credential | MD
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Telephone | 703-751-2616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0101023946
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License Number State | VA
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