Provider Demographics
NPI:1982675583
Name:FRASER, LEWIS KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:KEITH
Last Name:FRASER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:646 COX CREEK PKWY
Mailing Address - Street 2:STE A
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1105
Mailing Address - Country:US
Mailing Address - Phone:256-760-1771
Mailing Address - Fax:256-760-9149
Practice Address - Street 1:646 COX CREEK PKWY
Practice Address - Street 2:STE A
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1105
Practice Address - Country:US
Practice Address - Phone:256-760-1771
Practice Address - Fax:256-760-9149
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL00006384207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C75164Medicare UPIN