Provider Demographics
NPI:1881820389
Name:SEILER SKIN COSMETIC LASER AND AESTHETICS CENTER
Entity Type:Organization
Organization Name:SEILER SKIN COSMETIC LASER AND AESTHETICS CENTER
Other - Org Name:PREMIER COSMETIC LASER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SEILER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:205-870-0204
Mailing Address - Street 1:2700 ROGERS DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2054
Mailing Address - Country:US
Mailing Address - Phone:205-870-0204
Mailing Address - Fax:205-870-0224
Practice Address - Street 1:2700 ROGERS DR
Practice Address - Street 2:SUITE 101
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-2054
Practice Address - Country:US
Practice Address - Phone:205-870-0204
Practice Address - Fax:205-870-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26759208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty