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Organization
FREDERICK T FEASTER MD INC
Active
Organization
FREDERICK T FEASTER MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK THOMASON FEASTER M.D. (PRESIDENT)
(727) 822-4729
Entity
Organization
Contact information
Practice address
2200 16TH ST N, ST PETERSBURG, FL 33704-3106
(727) 822-4729
(727) 894-5744
Mailing address
2200 16TH ST N, ST PETERSBURG, FL 33704-3106
(727) 822-4729
(727) 894-5744
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME79534
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1716568008
CIGNA
—
01
—
4409061
AETNA
—
Enumeration date
09/27/2006
Last updated
08/22/2020
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