Provider Demographics
NPI:1437142890
Name:BARNES, ALECIA LANE (OD)
Entity Type:Individual
Prefix:
First Name:ALECIA
Middle Name:LANE
Last Name:BARNES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 LOWER SHILOH WAY
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5430
Mailing Address - Country:US
Mailing Address - Phone:919-472-4070
Mailing Address - Fax:919-472-4069
Practice Address - Street 1:1004 LOWER SHILOH WAY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-5430
Practice Address - Country:US
Practice Address - Phone:919-472-4070
Practice Address - Fax:919-472-4069
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1644152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0916XOtherBLUECROSS
NC410048146OtherRAILROAD MEDICARE
NC890916XMedicaid
NC2470317Medicare PIN