Individual
LORI ELLEN KAUFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 WHITESPORT DR SW, SUITE 201, HUNTSVILLE, AL 35801-6452
(256) 882-9777
(256) 882-9188
Mailing address
400 WHITESPORT DR SW, SUITE 201, HUNTSVILLE, AL 35801-6452
(256) 882-9777
(256) 882-9188
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14161
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14161
LICENSE
AL
01
—
4113939
AETNA
AL
01
—
63-1174000
TAX ID
AL
01
—
81959
BLUE CROSS BLUE SHIELD
AL
Enumeration date
01/26/2007
Last updated
07/01/2010
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