Provider Demographics
NPI:1548318603
Name:WILLIAM F. PITTENGER, JR., O.D., P.C.
Entity type:Organization
Organization Name:WILLIAM F. PITTENGER, JR., O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:B
Authorized Official - Last Name:PITTENGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-536-4489
Mailing Address - Street 1:806 REGAL DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5603
Mailing Address - Country:US
Mailing Address - Phone:256-536-4489
Mailing Address - Fax:256-536-4399
Practice Address - Street 1:806 REGAL DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5603
Practice Address - Country:US
Practice Address - Phone:256-536-4489
Practice Address - Fax:256-536-4399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH778Medicare ID - Type UnspecifiedGROUP MEDICARE #