Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 5101016407 | MI |
Y | 207VX0201X | Gynecologic Oncologist | 9182745555 | OK |
NPI | 1215054622 |
---|---|
Provider Name | Roger K Pfeiffer |
First Address | Owasso, OK 74055-4674 |
Second Address | Owasso, OK 74055-4674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 07/08/2013 |