Provider Demographics
NPI:1629005459
Name:FETZER-CLAIR UROLOGY ASSOCIATES LLP
Entity Type:Organization
Organization Name:FETZER-CLAIR UROLOGY ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:E
Authorized Official - Last Name:FETZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-770-0616
Mailing Address - Street 1:1230 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6212
Mailing Address - Country:US
Mailing Address - Phone:610-770-0616
Mailing Address - Fax:610-770-0587
Practice Address - Street 1:1230 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6212
Practice Address - Country:US
Practice Address - Phone:610-770-0616
Practice Address - Fax:610-770-0587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
028155Medicare ID - Type Unspecified