Provider Demographics
NPI:1164640736
Name:AMSLER, FRED R JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:R
Last Name:AMSLER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1738 E 3RD ST
Mailing Address - Street 2:#316
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3870
Mailing Address - Country:US
Mailing Address - Phone:570-525-3675
Mailing Address - Fax:
Practice Address - Street 1:1738 E 3RD ST
Practice Address - Street 2:#316
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3870
Practice Address - Country:US
Practice Address - Phone:570-525-3675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD027066L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD027066OtherSTATE MEDICAL LICENCE
PAC-27514Medicare UPIN