Provider Demographics
NPI:1063086262
Name:KUFAHL & PEEPLES MANAGEMENT
Entity type:Organization
Organization Name:KUFAHL & PEEPLES MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUFAHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-787-5001
Mailing Address - Street 1:4113 BARRY PL
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1203
Mailing Address - Country:US
Mailing Address - Phone:470-545-1490
Mailing Address - Fax:
Practice Address - Street 1:4113 BARRY PL
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-1203
Practice Address - Country:US
Practice Address - Phone:470-545-1490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1306466602OtherNPI