Basic Information
| Provider Information | |||||||||
| NPI: | 1740393339 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAUFMAN | ||||||||
| FirstName: | MARC | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 804 SCOTT NIXON MEMORIAL DR | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309072464 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2727 W MARTIAN LUTHER KING BLVD. | ||||||||
| Address2: | TAMPA MEDICAL TOWER, STE. 300 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003944445 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 08/01/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | ME55165 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207LC0200X | ME55165 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207LP2900X | ME55165 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP3000X | ME55165 | FL | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pediatric Anesthesiology | 208VP0014X | ME55165 | FL | N | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 208VP0000X | ME55165 | FL | N | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine |
No ID Information.