Provider Demographics
NPI:1609388032
Name:KAUFMANN, MARTIN WESLEY
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:WESLEY
Last Name:KAUFMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6215 E 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-9230
Mailing Address - Country:US
Mailing Address - Phone:303-667-5399
Mailing Address - Fax:
Practice Address - Street 1:10184 E I25 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:FIRESTONE
Practice Address - State:CO
Practice Address - Zip Code:80504-5445
Practice Address - Country:US
Practice Address - Phone:720-534-9961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health