# FREDERICK T FEASTER MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851482830
- **Authorized official:** DR. FREDERICK THOMASON FEASTER M.D. (PRESIDENT)
- **Authorized official phone:** (727) 822-4729

## Contact information

- **Practice address:** 2200 16TH ST N, ST PETERSBURG, FL 33704-3106
- **Practice address phone:** (727) 822-4729
- **Practice address fax:** (727) 894-5744
- **Mailing address:** 2200 16TH ST N, ST PETERSBURG, FL 33704-3106
- **Mailing address phone:** (727) 822-4729
- **Mailing address fax:** (727) 894-5744

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | ME79534 | FL | Yes |

## Other

- **Enumeration date:** 09/27/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1716568008 | CIGNA | — |
| 01 | — | 4409061 | AETNA | — |