Individual
MR. FRED L BIRMINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1173 ROBERT BLVD, SLIDELL, LA 70458-2013
(985) 847-0081
(985) 639-9576
Mailing address
150 W PINEWOOD DR, SLIDELL, LA 70458-1363
(985) 847-0081
(985) 639-9576
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
984-213T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1385042
—
LA
Enumeration date
04/13/2006
Last updated
07/08/2007
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