Provider Demographics
NPI:1154492924
Name:KAUFFMAN, JOSEPH LOREN
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LOREN
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-1712
Mailing Address - Country:US
Mailing Address - Phone:717-248-2506
Mailing Address - Fax:
Practice Address - Street 1:247 E 3RD ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-1712
Practice Address - Country:US
Practice Address - Phone:717-248-2506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019576150002Medicaid
PADD9068OtherPALMETTO RAILROAD MEDICAR
PA090769Medicare ID - Type Unspecified
PA0019576150002Medicaid