Healthcare Provider Details

I. General information

NPI: 1689721557
Provider Name (Legal Business Name): ELIZABETH B PITCHFORD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 11/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11588 PULASKI PIKE
TONEY AL
35773
US

IV. Provider business mailing address

515 SPARKMAN DR NW
HUNTSVILLE AL
35816-3417
US

V. Phone/Fax

Practice location:
  • Phone: 256-693-1006
  • Fax: 256-428-7561
Mailing address:
  • Phone: 256-428-7560
  • Fax: 256-428-7561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.31611
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0069476
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: