Provider Demographics
NPI:1164440350
Name:BARENTINE, EDWARD NEIL (OD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:NEIL
Last Name:BARENTINE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 MCLAURIN RD
Mailing Address - Street 2:GREEN PASTURES FARM
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-7585
Mailing Address - Country:US
Mailing Address - Phone:919-937-5700
Mailing Address - Fax:919-837-5700
Practice Address - Street 1:1046 MCLAURIN RD
Practice Address - Street 2:GREEN PASTURES FARM
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-7585
Practice Address - Country:US
Practice Address - Phone:919-937-5700
Practice Address - Fax:919-837-5700
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1976152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist