Individual
JOHNATHON D. KUPFNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1584 JACKSON CREEK PARKWAY, STE 120, COLORADO SPRINGS, CO 80132
(719) 364-9930
(719) 364-9939
Mailing address
1584 JACKSON CREEK PARKWAY, STE 120, COLORADO SPRINGS, CO 80132
(719) 364-9930
(719) 364-9939
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA3508
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48039047
—
CO
Enumeration date
09/22/2008
Last updated
03/30/2016
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