Provider Demographics
NPI:1083604664
Name:CAMP, JENNIFER JOYCE (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:JOYCE
Last Name:CAMP
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:CAMP
Other - Last Name:ORR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:248 LAKE CAROLINA BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7539
Mailing Address - Country:US
Mailing Address - Phone:210-663-1443
Mailing Address - Fax:
Practice Address - Street 1:733 FASHION DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7936
Practice Address - Country:US
Practice Address - Phone:803-223-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6163T152W00000X
SC1921152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist