Healthcare Provider Details

I. General information

NPI: 1548312499
Provider Name (Legal Business Name): ROSWELL R. PFISTER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2198 COLUMBIANA RD SUITE 200
VESTAVIA HILLS AL
35216-2567
US

IV. Provider business mailing address

2198 COLUMBIANA RD SUITE 200
VESTAVIA HILLS AL
35216-2567
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-2837
  • Fax: 205-877-1777
Mailing address:
  • Phone: 205-877-2837
  • Fax: 205-877-1777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROSWELL R PFISTER
Title or Position: PRESIDENT
Credential: MD
Phone: 205-877-2837