Provider Demographics
NPI:1881393429
Name:BURT, ALLISON LEE (PA-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:LEE
Last Name:BURT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:LEE
Other - Last Name:FISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1415 3RD AVE S APT 726
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1541
Mailing Address - Country:US
Mailing Address - Phone:770-262-4836
Mailing Address - Fax:
Practice Address - Street 1:1601 5TH AVENUE SOUTH
Practice Address - Street 2:BENJAMIN RUSSELL BUILDING
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-638-9174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.20882080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine