Provider Demographics
NPI:1154654127
Name:TARR, JEFFREY REILE BRYSON (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:REILE BRYSON
Last Name:TARR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5380 US HIGHWAY 158
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-6907
Mailing Address - Country:US
Mailing Address - Phone:336-940-2015
Mailing Address - Fax:336-940-2069
Practice Address - Street 1:5380 US HIGHWAY 158
Practice Address - Street 2:SUITE 100
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006-6907
Practice Address - Country:US
Practice Address - Phone:336-940-2015
Practice Address - Fax:336-940-2069
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2176152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist