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General NPI Number Information
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NPI Number | 1235330374
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Entity Type | Individual
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Provider Name | JONATHAN C PFEIFER MD
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Gender | Male
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 101 MEDICAL DR
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City | DOTHAN
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State | AL
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Zip | 36303-6903
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Country | US
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Telephone | 334-702-7222
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Fax | 334-702-1944
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Provider Business Mailing Address
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Address Line | 101 MEDICAL DR
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City | DOTHAN
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State | AL
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Zip | 36303-6903
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Country | US
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Telephone | 334-702-7222
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Fax | 334-702-1944
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 57009001
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 31125
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License Number State | AL
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