Provider Demographics
NPI:1699755470
Name:KAILER, ALISON MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:MARIE
Last Name:KAILER
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 1:573 BATTEN BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-8662
Mailing Address - Country:US
Mailing Address - Phone:850-619-4875
Mailing Address - Fax:
Practice Address - Street 1:21141 STATE HIGHWAY 59
Practice Address - Street 2:
Practice Address - City:ROBERTSDALE
Practice Address - State:AL
Practice Address - Zip Code:36567-6740
Practice Address - Country:US
Practice Address - Phone:251-947-4403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005019954152W00000X
ALR-247-TA-A35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist