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General NPI Number Information
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NPI Number | 1053396465
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Entity Type | Individual
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Provider Name | FRED B SETZER JR. OD
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Gender | Male
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | ONE WEST LAKESHORE DRIVE
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City | BIRMINGHAM
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State | AL
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Zip | 35209-7271
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Country | US
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Telephone | 205-941-2020
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Fax | 205-397-4190
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Provider Business Mailing Address
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Address Line | 324C EDWARDS LAKE PARKWAY SUITE 100
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3218
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Country | US
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Telephone | 205-949-2020
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Fax | 205-949-1400
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S364TA082
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License Number State | AL
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