Healthcare Provider Details

I. General information

NPI: 1174559660
Provider Name (Legal Business Name): BRET L FISHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W LAKESHORE DR STE 220
HOMEWOOD AL
35209-7271
US

IV. Provider business mailing address

3240 EDWARDS LAKE PKWY STE 100
BIRMINGHAM AL
35235-3128
US

V. Phone/Fax

Practice location:
  • Phone: 205-949-2020
  • Fax: 205-949-1400
Mailing address:
  • Phone: 205-949-2020
  • Fax: 205-949-1400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME 64480
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME 64480
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: