Provider Demographics
NPI:1407859531
Name:SIVLEY, MELANIE D (OD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:D
Last Name:SIVLEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MELANIE
Other - Middle Name:S
Other - Last Name:CROOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1716 UNIVERSITY BLVD
Mailing Address - Street 2:HPB G080
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0010
Mailing Address - Country:US
Mailing Address - Phone:205-975-2020
Mailing Address - Fax:205-934-6755
Practice Address - Street 1:1716 UNIVERSITY BLVD
Practice Address - Street 2:HPB G080
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0010
Practice Address - Country:US
Practice Address - Phone:205-975-2020
Practice Address - Fax:205-934-6755
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS733TA221152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP00051862OtherMEDICARE TRAVELERS
AL09931505Medicaid
AL00001961935OtherUNITED HEALTHCARE
ALU21448OtherVIVA HEALTH
ALU21448OtherHEALTHSPRINGS
AL051554014Medicare PIN
AL00001961935OtherUNITED HEALTHCARE
AL051505772Medicare PIN