Provider Demographics
NPI:1972157733
Name:HARING, CAITLYN (OD)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:
Last Name:HARING
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 1:9603 MALL RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-8540
Mailing Address - Country:US
Mailing Address - Phone:304-292-7240
Mailing Address - Fax:
Practice Address - Street 1:730 VENTURE DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-7306
Practice Address - Country:US
Practice Address - Phone:304-292-7240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2062-IOD1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist