Provider Demographics
NPI:1134139587
Name:SEMES, LEO (OD)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:
Last Name:SEMES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 UNIVERSITY BLVD
Mailing Address - Street 2:HPB G080A
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0010
Mailing Address - Country:US
Mailing Address - Phone:205-975-2020
Mailing Address - Fax:205-934-6755
Practice Address - Street 1:1716 UNIVERSITY BLVD
Practice Address - Street 2:HPB G080A
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0010
Practice Address - Country:US
Practice Address - Phone:205-975-2020
Practice Address - Fax:205-934-6755
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS575TA121152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51059816OtherBCBS OF ALABAMA
MS07357851Medicaid
LA1586382Medicaid
AL51059879OtherBCBS OF ALABAMA
AL000059879Medicaid
LA1586382Medicaid
AL000059879Medicare PIN
AL000059816Medicare PIN
ALU01858Medicare UPIN
AL1387502Medicare ID - Type UnspecifiedTRAVELERS
0279620003Medicare NSC
AL51059816OtherBCBS OF ALABAMA