Provider Demographics
NPI:1356393367
Name:DAVID S PFOFF MD PC
Entity type:Organization
Organization Name:DAVID S PFOFF MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SONGER
Authorized Official - Last Name:PFOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:785-890-6196
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:GOODLAND
Mailing Address - State:KS
Mailing Address - Zip Code:67735-0102
Mailing Address - Country:US
Mailing Address - Phone:785-890-6196
Mailing Address - Fax:785-890-6196
Practice Address - Street 1:220 W 2ND ST
Practice Address - Street 2:
Practice Address - City:GOODLAND
Practice Address - State:KS
Practice Address - Zip Code:67735-1602
Practice Address - Country:US
Practice Address - Phone:785-890-6196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18036207W00000X
NE17630207W00000X
KS04-16837207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID
KS110196Medicare ID - Type Unspecified
B91056Medicare UPIN