Provider Demographics
NPI:1144333733
Name:PIFER, DAVID ANTHONY (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ANTHONY
Last Name:PIFER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1636
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-1636
Mailing Address - Country:US
Mailing Address - Phone:423-265-4306
Mailing Address - Fax:423-265-4404
Practice Address - Street 1:629 MARKET ST
Practice Address - Street 2:SUITE 115
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-4884
Practice Address - Country:US
Practice Address - Phone:423-265-4306
Practice Address - Fax:423-265-4404
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN1896152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3942008Medicaid
TN4443590001Medicare NSC
TN3942008Medicare PIN
TNP00102148Medicare PIN
TNU71360Medicare UPIN