Provider Demographics
NPI:1376599589
Name:KAUFMAN, JASON ROSS (DC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ROSS
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9755 N 90TH ST
Mailing Address - Street 2:SUITE A200
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5046
Mailing Address - Country:US
Mailing Address - Phone:480-621-2213
Mailing Address - Fax:480-621-3314
Practice Address - Street 1:9755 N 90TH ST
Practice Address - Street 2:SUITE A200
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5046
Practice Address - Country:US
Practice Address - Phone:480-621-2213
Practice Address - Fax:480-621-3314
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008710111N00000X
AZ7793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor