Healthcare Provider Details

I. General information

NPI: 1295652303
Provider Name (Legal Business Name): ALISON MCCOMBS-BUCHANAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3013 WINGHAVEN BLVD
O FALLON MO
63368-3600
US

IV. Provider business mailing address

9979 WINGHAVEN BLVD STE 202
O FALLON MO
63368-3628
US

V. Phone/Fax

Practice location:
  • Phone: 636-561-3937
  • Fax:
Mailing address:
  • Phone: 636-695-8555
  • Fax: 636-695-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2026030579
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: