Organization
BIRMINGHAM OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED L. BIRMINGHAM OD (OWNER)
(985) 847-0081
Entity
Organization
Contact information
Practice address
1173 ROBERT BLVD, SLIDELL, LA 70458-2082
(985) 847-0081
Mailing address
1173 ROBERT BLVD, SLIDELL, LA 70458-2082
(985) 847-0081
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
984213T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1385042
—
LA
Enumeration date
10/05/2016
Last updated
10/05/2016
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