Provider Demographics
NPI:1023677143
Name:FOSTER, RONALD BRAD
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:BRAD
Last Name:FOSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 OPELIKA RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-2811
Mailing Address - Country:US
Mailing Address - Phone:334-821-8889
Mailing Address - Fax:334-821-4733
Practice Address - Street 1:1955 OPELIKA RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-2811
Practice Address - Country:US
Practice Address - Phone:334-821-8889
Practice Address - Fax:334-821-4733
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician