Healthcare Provider Details

I. General information

NPI: 1811972813
Provider Name (Legal Business Name): DENISE RENEE BAREFIELD PENDLETON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 12/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE INDEEPENDENCE PLAZA, STE 810 BROOKWOOD OPHTHALMOLOGY INC
HOMEWOOD AL
35209
US

IV. Provider business mailing address

1032 2ND ST W
BIRMINGHAM AL
35204
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-2921
  • Fax: 205-877-8494
Mailing address:
  • Phone: 205-873-0840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4482
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number019873
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: