Provider Demographics
NPI:1477696656
Name:KISER, MELANIE SUZANNE (OD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:SUZANNE
Last Name:KISER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 US HIGHWAY 70 SE
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-5106
Mailing Address - Country:US
Mailing Address - Phone:828-323-8833
Mailing Address - Fax:828-322-8687
Practice Address - Street 1:1960 US HIGHWAY 70 SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-5106
Practice Address - Country:US
Practice Address - Phone:828-323-8833
Practice Address - Fax:828-322-8687
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN1430152W00000X
NCNC1568152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU36656Medicare UPIN