Individual
DR. MITCHELL HESTON KAUFMAN
Active
Individual
DR. MITCHELL HESTON KAUFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
40120
SC
2084N0400X
Neurology Physician
G57902
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163580001
—
AR
05
—
401201
—
SC
01
—
5N745
BLUE CROSS BLUE SHIELD
AR
01
—
E-5065
STATE LICENSE
AR
Enumeration date
08/19/2006
Last updated
10/25/2016
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