Provider Demographics
NPI:1366444986
Name:KAUFFMAN, NYLE DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:NYLE
Middle Name:DEAN
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:PO BOX 1638
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52244-1638
Mailing Address - Country:US
Mailing Address - Phone:319-688-7376
Mailing Address - Fax:319-358-2628
Practice Address - Street 1:2460 TOWNCREST DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6622
Practice Address - Country:US
Practice Address - Phone:319-338-7862
Practice Address - Fax:319-338-2517
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18221207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0099432Medicaid
IA03076OtherWELLMARK
IAA01057Medicare UPIN
IA0099432Medicaid