Provider Demographics
NPI:1497726368
Name:KAUFMAN, JOSEPH ARNOLD (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ARNOLD
Last Name:KAUFMAN
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 1:1173 S PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-6204
Mailing Address - Country:US
Mailing Address - Phone:702-480-5253
Mailing Address - Fax:702-320-3849
Practice Address - Street 1:105 N. MAIN ST.
Practice Address - Street 2:SUITE #206
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720
Practice Address - Country:US
Practice Address - Phone:702-480-5253
Practice Address - Fax:702-320-3849
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3572207RC0000X
UT10728700-1205207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002621Medicaid
C96212Medicare UPIN
NV002002621Medicaid