Provider Demographics
NPI:1174559660
Name:FISHER, BRET L (MD)
Entity type:Individual
Prefix:MR
First Name:BRET
Middle Name:L
Last Name:FISHER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3240 EDWARDS LAKE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3128
Mailing Address - Country:US
Mailing Address - Phone:205-949-2020
Mailing Address - Fax:205-949-1400
Practice Address - Street 1:1 W LAKESHORE DR STE 220
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-7271
Practice Address - Country:US
Practice Address - Phone:205-949-2020
Practice Address - Fax:205-949-1400
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 64480208600000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373036100Medicaid
FL23079OtherBLUE CROSS & BLUE SHEILD
FL180039064OtherRAIL ROAD MEDICARE
FL23079OtherBLUE CROSS & BLUE SHEILD
FL180039064OtherRAIL ROAD MEDICARE