Provider Demographics
NPI:1447662242
Name:SCOTT PFITZER MD LLC
Entity type:Organization
Organization Name:SCOTT PFITZER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:H
Authorized Official - Last Name:PFITZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-505-6826
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016-0116
Mailing Address - Country:US
Mailing Address - Phone:256-505-6826
Mailing Address - Fax:256-582-1100
Practice Address - Street 1:11491 US HIGHWAY 431
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-0136
Practice Address - Country:US
Practice Address - Phone:256-505-6826
Practice Address - Fax:256-582-1100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL30040208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1326209685OtherINDIVIDUAL NPI