Healthcare Provider Details

I. General information

NPI: 1124107453
Provider Name (Legal Business Name): FREDRIC WARREN FEIST SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 5TH AVE NW
ATTALLA AL
35954-2214
US

IV. Provider business mailing address

425 5TH AVE NW
ATTALLA AL
35954-2214
US

V. Phone/Fax

Practice location:
  • Phone: 256-492-7800
  • Fax: 256-494-5536
Mailing address:
  • Phone: 256-492-7800
  • Fax: 256-494-5536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number3258
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: