MEDICARE: DR. KAYLA L. THOMASON O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	S-D57-TA-A59	AL
2	152WL0500X	Low Vision Rehabilitation Optometrist	S-D57-TA-A59	AL

General Provider Information

NPI Number	:	1518315365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAYLA L. THOMASON O.D.

Provider Business Mailing Address
First Line	:	PO BOX 59449
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35259-9449
Country	:	US
Telephone Number	:	205-876-8988
Fax Number	:	205-723-0808

Provider Business Practice Location Address
First Line	:	7067 VETERANS PKWY STE 240
Second Line	:
City	:	PELL CITY
State	:	AL
Zip	:	35125-5128
Country	:	US
Telephone Number	:	205-876-8988
Fax Number	:	205-723-0808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2016
Last Update Date	:	07/22/2024

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