Provider Demographics
NPI:1679627905
Name:KAUFFMAN, RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MEDICAL CT
Mailing Address - Street 2:
Mailing Address - City:OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:31068-2000
Mailing Address - Country:US
Mailing Address - Phone:478-458-9942
Mailing Address - Fax:478-458-9969
Practice Address - Street 1:300 MEDICAL CT
Practice Address - Street 2:
Practice Address - City:OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:31068-2000
Practice Address - Country:US
Practice Address - Phone:478-458-9942
Practice Address - Fax:478-458-9969
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA18682207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD45816Medicare UPIN