Provider Demographics
NPI:1265451157
Name:KAUFFMAN, RICHARD D (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3707 BRAMBLETON AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3658
Mailing Address - Country:US
Mailing Address - Phone:540-725-7800
Mailing Address - Fax:540-989-6752
Practice Address - Street 1:3707 BRAMBLETON AVE STE 2
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018
Practice Address - Country:US
Practice Address - Phone:540-725-7800
Practice Address - Fax:540-989-6752
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0102202548207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine