Provider Demographics
NPI:1427032697
Name:NEUFELD, KENNETH R (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:R
Last Name:NEUFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5901A PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:STE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5382
Mailing Address - Country:US
Mailing Address - Phone:678-892-2020
Mailing Address - Fax:678-538-1950
Practice Address - Street 1:5995 BARFIELD RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4411
Practice Address - Country:US
Practice Address - Phone:404-256-1507
Practice Address - Fax:404-256-1981
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA054836207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582209517OtherWORK COMP
GA7806517OtherAETNA
GA911549OtherBCBS
GA911550OtherBCBS
GAP00301618OtherRR MEDICARE
GA328678OtherWELLCARE
GA383428098BMedicaid
GA383428098DMedicaid
GA911549OtherBCBS
GA911550OtherBCBS
GA582209517OtherWORK COMP
1078920004Medicare NSC