Provider Demographics
NPI:1417907981
Name:STEVEN L KAUFMAN, MD, PHD, PC
Entity Type:Organization
Organization Name:STEVEN L KAUFMAN, MD, PHD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:970-498-8346
Mailing Address - Street 1:1629 BLUE SPRUCE DR
Mailing Address - Street 2:STE 208
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-5415
Mailing Address - Country:US
Mailing Address - Phone:970-498-8346
Mailing Address - Fax:
Practice Address - Street 1:1120 E ELIZABETH ST
Practice Address - Street 2:BLDG G, STE 4
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4044
Practice Address - Country:US
Practice Address - Phone:970-498-8346
Practice Address - Fax:970-419-8346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39970208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COKAK65432OtherBCBS
CO87407345Medicaid
COC553518Medicare ID - Type Unspecified