Provider Demographics
NPI:1235588062
Name:KELLER ALVAREZ, MELISSA (OD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:KELLER ALVAREZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:CATHERINE
Other - Last Name:KELLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:350 MARTIN LUTHER KING JR BLVD UNIT A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-4387
Mailing Address - Country:US
Mailing Address - Phone:912-483-6600
Mailing Address - Fax:912-454-6040
Practice Address - Street 1:350 MARTIN LUTHER KING JR BLVD UNIT A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-4387
Practice Address - Country:US
Practice Address - Phone:912-483-6600
Practice Address - Fax:912-454-6040
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002953152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist