Provider Demographics
NPI:1952822694
Name:BERRY, SARAH M (OD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:BERRY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:535 JACK WARNER PKWY NE STE B1
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5715
Mailing Address - Country:US
Mailing Address - Phone:205-556-2121
Mailing Address - Fax:205-554-0152
Practice Address - Street 1:535 JACK WARNER PKWY NE STE B1
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5715
Practice Address - Country:US
Practice Address - Phone:205-556-2121
Practice Address - Fax:614-466-5115
Is Sole Proprietor?:No
Enumeration Date:2017-07-03
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR-264-TA-B36152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist