Provider Demographics
NPI:1063415339
Name:PFEIFFER, RALPH B JR (MD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:B
Last Name:PFEIFFER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:171 MOBILE INFIRMARY BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3509
Mailing Address - Country:US
Mailing Address - Phone:251-432-0558
Mailing Address - Fax:251-432-0554
Practice Address - Street 1:171 MOBILE INFIRMARY BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3509
Practice Address - Country:US
Practice Address - Phone:251-432-0558
Practice Address - Fax:251-432-0554
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2014-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL000057782086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000030016Medicaid
ALA26197Medicare UPIN
AL30016Medicare ID - Type UnspecifiedVASCULAR SURGERY