Healthcare Provider Details

I. General information

NPI: 1558365544
Provider Name (Legal Business Name): THOMAS M ALLISON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 05/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 10TH AVE S STE 402
BIRMINGHAM AL
35205-1248
US

IV. Provider business mailing address

2700 10TH AVE S STE 402
BIRMINGHAM AL
35205-1248
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-0439
  • Fax: 205-939-1462
Mailing address:
  • Phone: 205-933-0439
  • Fax: 205-939-1462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number7074
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: