Provider Demographics
NPI:1083845614
Name:NORWOOD, ALLISON BURKS (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:BURKS
Last Name:NORWOOD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:837 KINGS CROSSING DR STE 10
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-0952
Mailing Address - Country:US
Mailing Address - Phone:662-842-3037
Mailing Address - Fax:662-842-3869
Practice Address - Street 1:837 KINGS CROSSING DR STE 10
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-0952
Practice Address - Country:US
Practice Address - Phone:662-842-3037
Practice Address - Fax:662-842-3869
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS810152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06578016Medicaid