Provider Demographics
NPI:1801868088
Name:PFISTER, DARYL R (MD)
Entity Type:Individual
Prefix:
First Name:DARYL
Middle Name:R
Last Name:PFISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 N 22ND ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4701
Mailing Address - Country:US
Mailing Address - Phone:602-955-1000
Mailing Address - Fax:602-508-4830
Practice Address - Street 1:6101 S RURAL RD STE 115
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-2910
Practice Address - Country:US
Practice Address - Phone:480-517-0047
Practice Address - Fax:602-508-4830
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24384207W00000X, 207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWMBFX09Medicare PIN
AZZ18WCGPB29Medicare PIN
AZZ18WCGR20Medicare PIN
AZZ18WCGFR33Medicare PIN
AZF37058Medicare UPIN