Provider Demographics
NPI:1518106525
Name:RONALD P. KUFNER M.D., P.C.
Entity Type:Organization
Organization Name:RONALD P. KUFNER M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KUFNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:616-308-9860
Mailing Address - Street 1:4633 W KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8341
Mailing Address - Country:US
Mailing Address - Phone:616-308-9860
Mailing Address - Fax:616-874-8218
Practice Address - Street 1:5050 CASCADE RD SE
Practice Address - Street 2:SUITE C
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3707
Practice Address - Country:US
Practice Address - Phone:616-308-9860
Practice Address - Fax:616-874-8218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2012-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain