Provider Demographics
NPI:1659386241
Name:LUPFER, ALEXA RAWLINGS (OD)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:RAWLINGS
Last Name:LUPFER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:LEIGH
Other - Last Name:RAWLINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16525 BIRKDALE COMMONS PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078
Mailing Address - Country:US
Mailing Address - Phone:704-896-3311
Mailing Address - Fax:704-896-5514
Practice Address - Street 1:16525 BIRKDALE COMMONS PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:704-896-3311
Practice Address - Fax:704-896-5514
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC 1957152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC093TNOtherBCBS
093TNOtherNC HEALTH CHOICE
371457054OtherSUPERIOR VISION
093TNOtherNC HEALTH CHOICE
V09196Medicare UPIN