Provider Demographics
NPI:1801900253
Name:KAUFFMAN, JEFFREY NEAL
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:NEAL
Last Name:KAUFFMAN
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 1:1124 E ELIZABETH ST
Mailing Address - Street 2:BLDG C
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4052
Mailing Address - Country:US
Mailing Address - Phone:970-484-0798
Mailing Address - Fax:
Practice Address - Street 1:1124 E ELIZABETH ST STE C
Practice Address - Street 2:BLDG C
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4051
Practice Address - Country:US
Practice Address - Phone:970-484-0798
Practice Address - Fax:970-482-0679
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0032333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1323336Medicaid
CO1323336Medicaid
CO1323336Medicaid