Provider Demographics
NPI:1053396465
Name:SETZER, FRED B JR (OD)
Entity type:Individual
Prefix:
First Name:FRED
Middle Name:B
Last Name:SETZER
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324C EDWARDS LAKE PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3218
Mailing Address - Country:US
Mailing Address - Phone:205-949-2020
Mailing Address - Fax:205-949-1400
Practice Address - Street 1:ONE WEST LAKESHORE DRIVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-7271
Practice Address - Country:US
Practice Address - Phone:205-941-2020
Practice Address - Fax:205-397-4190
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS364TA082152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T69060Medicare UPIN
AL36309Medicare ID - Type Unspecified