Provider Demographics
NPI:1629022751
Name:KAUFFMAN, JOHN H III (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:KAUFFMAN
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 CUNNINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2569
Mailing Address - Country:US
Mailing Address - Phone:757-826-3937
Mailing Address - Fax:757-825-0381
Practice Address - Street 1:2157 CUNNINGHAM DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2569
Practice Address - Country:US
Practice Address - Phone:757-826-3937
Practice Address - Fax:757-825-0381
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001007152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009204547Medicaid