Provider Demographics
NPI:1891420311
Name:KELSEY ALEXANDER MD, LLC
Entity Type:Organization
Organization Name:KELSEY ALEXANDER MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-822-0190
Mailing Address - Street 1:4B SKIDAWAY VILLAGE WALK
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411
Mailing Address - Country:US
Mailing Address - Phone:912-598-6322
Mailing Address - Fax:
Practice Address - Street 1:4B SKIDAWAY VILLAGE WALK
Practice Address - Street 2:SUITE B
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31411
Practice Address - Country:US
Practice Address - Phone:912-598-6322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty