=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346415411
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WILLIAM LENOX PFAFF III M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2008
-----------------------------------------------------
Last Update Date | 06/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18947 JOHN J WILLIAMS HWY MEDICAL ARTS BUILDING, UNIT 311
-----------------------------------------------------
City | REHOBOTH BEACH
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19971-4477
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-231-4333
-----------------------------------------------------
Fax | 302-231-4414
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18947 JOHN J WILLIAMS HWY MEDICAL ARTS BUILDING, UNIT 311
-----------------------------------------------------
City | REHOBOTH BEACH
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19971-4477
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-231-4333
-----------------------------------------------------
Fax | 302-231-4414
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | MD429103
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | C10008913
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207XS0117X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery of the Spine Physician
-----------------------------------------------------
License Number | C10008913
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------