Healthcare Provider Details

I. General information

NPI: 1952822694
Provider Name (Legal Business Name): SARAH M. BERRY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 07/22/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 GADSDEN HWY STE 120
BIRMINGHAM AL
35235-4201
US

IV. Provider business mailing address

PO BOX 59449
BIRMINGHAM AL
35259-9449
US

V. Phone/Fax

Practice location:
  • Phone: 205-876-8988
  • Fax: 205-374-8534
Mailing address:
  • Phone: 205-876-8988
  • Fax: 205-374-8534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberR-264-TA-B36
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: