MEDICARE: ASHLEY SAVAGE OD

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	0000003632	TN
2	152W00000X	Optometrist	1972111995	AL
3	152W00000X	Optometrist	SE64TAC11	AL

General Provider Information

NPI Number	:	1972111995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY SAVAGE OD

Provider Business Mailing Address
First Line	:	PO BOX 207243
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-0760
Country	:	US
Telephone Number	:	636-200-4393
Fax Number	:	636-527-0766

Provider Business Practice Location Address
First Line	:	4500 VALLEYDALE RD STE 700
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-4634
Country	:	US
Telephone Number	:	205-995-0700
Fax Number	:	636-527-0766

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

Provider Enumeration Date	:	07/15/2020
Last Update Date	:	07/22/2021

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Directions to “ ASHLEY SAVAGE OD” Practice Location

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