MEDICARE: THOMAS M ALLISON M.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	207W00000X	Ophthalmology Physician	7074	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	180000402	OTHER	AL	PALMETTO GPA RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	051048659	OTHER	AL	BC/BS

General Provider Information

NPI Number	:	1558365544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS M ALLISON M.D.

Provider Business Mailing Address
First Line	:	2700 10TH AVE S
Second Line	:	STE 402
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1248
Country	:	US
Telephone Number	:	205-933-0439
Fax Number	:	205-939-1462

Provider Business Practice Location Address
First Line	:	2700 10TH AVE S
Second Line	:	STE 402
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1248
Country	:	US
Telephone Number	:	205-933-0439
Fax Number	:	205-939-1462

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	05/05/2009

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Directions to “ THOMAS M ALLISON M.D.” Practice Location

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