Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 45914 | AZ |
NPI | 1386854925 |
---|---|
Provider Name | Judah D Pifer |
First Address | Prescott, AZ 86305-7101 |
Second Address | Prescott, AZ 86305-7101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 12/09/2012 |