Individual
DR. MITCHELL HESTON KAUFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(201) 227-8000
(501) 221-5850
Mailing address
10001 LILE DR, LITTLE ROCK, AR 72205-6217
(201) 227-8000
(501) 221-5850
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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