Provider Demographics
NPI:1831636737
Name:PFEIL, WILLIAM JACKSON (MS, LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:JACKSON
Last Name:PFEIL
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 STADIUM DR
Mailing Address - Street 2:ROOM D107
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32304-4247
Mailing Address - Country:US
Mailing Address - Phone:850-644-7038
Mailing Address - Fax:850-645-9900
Practice Address - Street 1:403 STADIUM DR
Practice Address - Street 2:ROOM D107
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-4247
Practice Address - Country:US
Practice Address - Phone:850-644-7038
Practice Address - Fax:850-645-9900
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL16852255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer