Provider Demographics
NPI:1588892665
Name:KELLER, ALYSSA LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:LEIGH
Last Name:KELLER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:300 WINDING WOODS DR
Mailing Address - Street 2:SUITE 222
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-4771
Mailing Address - Country:US
Mailing Address - Phone:636-978-8600
Mailing Address - Fax:636-978-8602
Practice Address - Street 1:300 WINDING WOODS DR
Practice Address - Street 2:SUITE 222
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-4771
Practice Address - Country:US
Practice Address - Phone:636-978-8600
Practice Address - Fax:636-978-8602
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2012-06-30
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Provider Licenses
StateLicense IDTaxonomies
MO2009017184207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine