Basic Information
| Provider Information | |||||||||
| NPI: | 1932114311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRAZIER | ||||||||
| FirstName: | MARCELA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 18TH ST S | ||||||||
| Address2: | STE 601 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352333800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059752020 | ||||||||
| FaxNumber: | 2059346755 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 18TH ST S | ||||||||
| Address2: | STE 601 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352333800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053259620 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 08/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 08/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | S-A26-TA-608 | AL | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 009903435 | 05 | AL | MEDICAID | 51511228 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER | U91316 | 01 | AL | VIVA HEALTH | OTHER |