Provider Demographics
NPI:1508937665
Name:YUMA FOOT & ANKLE CARE, INC.
Entity Type:Organization
Organization Name:YUMA FOOT & ANKLE CARE, INC.
Other - Org Name:IRA L KAUFMAN, DPM
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:928-726-7772
Mailing Address - Street 1:1047 S BARDEAUX AVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-4132
Mailing Address - Country:US
Mailing Address - Phone:928-726-7772
Mailing Address - Fax:928-726-7742
Practice Address - Street 1:1150 W 24TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8368
Practice Address - Country:US
Practice Address - Phone:928-726-7772
Practice Address - Fax:928-726-7742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-12
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0402213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDE5835OtherRAILROAD MEDICARE
AZ330118Medicaid
AZ330118Medicaid
AZ5036440001Medicare NSC
T87766Medicare UPIN