Healthcare Provider Details

I. General information

NPI: 1932114311
Provider Name (Legal Business Name): MARCELA FRAZIER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 18TH ST S STE 601
BIRMINGHAM AL
35233-3800
US

IV. Provider business mailing address

700 18TH ST S STE 601
BIRMINGHAM AL
35233-3800
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-9620
  • Fax:
Mailing address:
  • Phone: 205-975-2020
  • Fax: 205-934-6755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS-A26-TA-608
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: