Fred G Fedok, MD
Individual provider Active NPI Facial Plastic Surgery Physician · Foley, AL
NPI 1760449656 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1760449656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Facial Plastic Surgery Physician 207YS0123X
- License
- 15147 (AL)
- Practice address
- 113 E Fern Ave
Foley, AL 36535-2806 - Phone
- (251) 943-6003
- Fax
- (251) 943-2429
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 1, 2025 through Jul 1, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MD028333E | PA | |
| Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician | 2082S0099X | 15147 | AL | |
| Facial Plastic Surgery Physician | 207YS0123X | 15147 | AL | Yes |
Addresses
Primary practice location
113 E Fern Ave
Foley, AL 36535-2806
Mailing address
113 E Fern Ave
Foley, AL 36535-2806
Phone (251) 943-6003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0011684000002 | Medicaid | PA |
Other providers in Foley, AL
- Eye Consultants of Foley LLC
- Family Tree Chiropractic LLC
- Family Vision and Hearing Company LLC
- Fast Pace Medical Clinic, PLLC
- Beatriz Favela
- Regina Valentine Felkner
- Ferrell Family Dental, P.C.
- Kathryn C Fetner
- Raymond R Fletcher
- Emily N Flynn
All providers in Foley, AL · Facial Plastic Surgery Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.