Provider Demographics
NPI:1336175439
Name:FRENETTE, JOSEPH ROLAND LUC (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH ROLAND
Middle Name:LUC
Last Name:FRENETTE
Suffix:
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 1:5057 PINNACLE SQ
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3216
Mailing Address - Country:US
Mailing Address - Phone:205-508-5300
Mailing Address - Fax:205-508-5552
Practice Address - Street 1:5057 PINNACLE SQ
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3216
Practice Address - Country:US
Practice Address - Phone:205-508-5300
Practice Address - Fax:205-508-5552
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16051207L00000X
ALAL16501207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL010033CE88731OtherSECTION 1011
ALE88731OtherVIVA
AL051511180OtherBLUE CROSS
AL000083967OtherBLUE CROSS
AL050045678OtherRAILROAD MEDICARE
AL000083967Medicaid
AL2674OtherHEALTHSPRING OF ALABAMA
MS00127023Medicaid
AL000083967Medicare PIN