Provider Demographics
NPI:1033242581
Name:MILLENDER, TARRA WRIGHT (MD)
Entity Type:Individual
Prefix:DR
First Name:TARRA
Middle Name:WRIGHT
Last Name:MILLENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TARRA
Other - Middle Name:MARIE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2170 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-2927
Mailing Address - Country:US
Mailing Address - Phone:910-295-2100
Mailing Address - Fax:910-295-5339
Practice Address - Street 1:2170 MIDLAND RD
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-2927
Practice Address - Country:US
Practice Address - Phone:910-295-2100
Practice Address - Fax:910-295-5339
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC116947207W00000X
NC2007-00722207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2066561Medicare PIN