Provider Demographics
NPI:1992737688
Name:PFEIFFER, DOUGLAS G (DC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:G
Last Name:PFEIFFER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:PENNSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18073-0045
Mailing Address - Country:US
Mailing Address - Phone:215-679-7800
Mailing Address - Fax:215-679-8728
Practice Address - Street 1:1543 LAYFIELD RD
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-1711
Practice Address - Country:US
Practice Address - Phone:215-679-7800
Practice Address - Fax:215-679-8728
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003161L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPF470331Medicare ID - Type Unspecified
PAT30616Medicare UPIN