Provider Demographics
NPI:1518014497
Name:PITCHFORD, CLOVIS WARREN (MD)
Entity Type:Individual
Prefix:
First Name:CLOVIS
Middle Name:WARREN
Last Name:PITCHFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2904 WESTCORP BLVD SW
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35805-6437
Mailing Address - Country:US
Mailing Address - Phone:256-533-1480
Mailing Address - Fax:256-535-0715
Practice Address - Street 1:2904 WESTCORP BLVD SW
Practice Address - Street 2:SUITE 107/108
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-6437
Practice Address - Country:US
Practice Address - Phone:256-533-1480
Practice Address - Fax:256-535-0715
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2008-0102207ZP0102X, 207ZH0000X
ALMD.31610207ZP0102X, 207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology