MEDICARE: DR. ALLISON WIRT OD, MS

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-F11TA-C77	AL

General Provider Information

NPI Number	:	1942928791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLISON WIRT OD, MS

Provider Business Mailing Address
First Line	:	4616 HIGHWAY 280
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-5028
Country	:	US
Telephone Number	:	205-408-4069
Fax Number	:

Provider Business Practice Location Address
First Line	:	4616 HIGHWAY 280
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-5028
Country	:	US
Telephone Number	:	205-408-4069
Fax Number	:

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

Provider Enumeration Date	:	08/18/2022
Last Update Date	:	03/05/2026

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