Provider Demographics
NPI:1134163496
Name:KAUFFMAN, DENNIS L (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:L
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1744 NW BUSINESS HWY 20
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OR
Mailing Address - Zip Code:97391
Mailing Address - Country:US
Mailing Address - Phone:541-336-5181
Mailing Address - Fax:541-336-7614
Practice Address - Street 1:1744 NW BUSINESS HWY 20
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OR
Practice Address - Zip Code:97391
Practice Address - Country:US
Practice Address - Phone:541-336-5181
Practice Address - Fax:541-336-7614
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD12389207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC93006Medicare UPIN