Provider Demographics
NPI:1639174154
Name:PFEIFFER, RALPH BURTON III (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:BURTON
Last Name:PFEIFFER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4300 W MAIN ST
Mailing Address - Street 2:STE 24
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1054
Mailing Address - Country:US
Mailing Address - Phone:334-793-1534
Mailing Address - Fax:334-793-6840
Practice Address - Street 1:4300 W MAIN ST
Practice Address - Street 2:STE 24
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1054
Practice Address - Country:US
Practice Address - Phone:334-793-1534
Practice Address - Fax:334-793-6840
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2014-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL265372086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51000716OtherAL BCBS # FOR OFFICE #2
AL009986025Medicaid
AL51000717OtherAL BCBS # FOR OFFICE #1
AL009986015Medicaid
AL009986025Medicaid
AL009986015Medicaid