Basic Information
| Provider Information | |||||||||
| NPI: | 1497726368 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAUFMAN | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | ARNOLD | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1173 S PANORAMA DR | ||||||||
| Address2: | |||||||||
| City: | CEDAR CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 847206204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024805253 | ||||||||
| FaxNumber: | 7023203849 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 N. MAIN ST. | ||||||||
| Address2: | SUITE #206 | ||||||||
| City: | CEDAR CITY | ||||||||
| State: | UT | ||||||||
| PostalCode: | 84720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7024805253 | ||||||||
| FaxNumber: | 7023203849 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 10/18/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 3572 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | 10728700-1205 | UT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 002002621 | 05 | NV | MEDICAID |