Provider Demographics
NPI:1619169331
Name:BARBARA J CIAMPA OD PA
Entity Type:Organization
Organization Name:BARBARA J CIAMPA OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:CIAMPA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:910-484-7139
Mailing Address - Street 1:201 S MCPHERSON CHURCH RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4974
Mailing Address - Country:US
Mailing Address - Phone:910-484-7139
Mailing Address - Fax:910-860-1187
Practice Address - Street 1:201 S MCPHERSON CHURCH RD
Practice Address - Street 2:SUITE 106
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4974
Practice Address - Country:US
Practice Address - Phone:910-484-7139
Practice Address - Fax:910-860-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1081152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2472627Medicare PIN