Provider Demographics
NPI:1710345574
Name:KAUFMAN, PATRICK CARR SR
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:CARR
Last Name:KAUFMAN
Suffix:SR
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 1:466 MARTIN LUTHER KING, JR. BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401
Mailing Address - Country:US
Mailing Address - Phone:912-662-8666
Mailing Address - Fax:912-233-3805
Practice Address - Street 1:466 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-4880
Practice Address - Country:US
Practice Address - Phone:912-662-8666
Practice Address - Fax:912-233-3805
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker