Healthcare Provider Details

I. General information

NPI: 1447491998
Provider Name (Legal Business Name): DEBORAH KELLER BLANSETT O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. DEBORAH ANN KELLER

II. Dates (important events)

Enumeration Date: 03/13/2009
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 FAIRFAX PARK
TUSCALOOSA AL
35406-2806
US

IV. Provider business mailing address

1720 UNIVERSITY BLVD STE 305
BIRMINGHAM AL
35233-1816
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-8620
  • Fax: 205-325-8547
Mailing address:
  • Phone: 205-325-8620
  • Fax: 205-325-8547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS872TA405
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6359T
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: