Provider Demographics
NPI:1417938622
Name:KAUFFMAN, WILLIAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
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 1:100 S HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEWVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17241-1409
Mailing Address - Country:US
Mailing Address - Phone:717-776-3114
Mailing Address - Fax:717-776-5020
Practice Address - Street 1:110 UNION HALL RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-8391
Practice Address - Country:US
Practice Address - Phone:717-991-3964
Practice Address - Fax:717-918-5782
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 044856L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012532330005Medicaid
P01320350OtherMEDICARE RAILROAD
PA0012532330003Medicaid
PAE88243Medicare UPIN
E88243Medicare UPIN
PA0012532330003Medicaid