Provider Demographics
NPI:1013983733
Name:GROVE, BARBARA LYNNE (OD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNNE
Last Name:GROVE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:B
Other - Middle Name:LYNNE
Other - Last Name:GROVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:681 FALMOUTH RD
Mailing Address - Street 2:UPPER LEVEL
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3327
Mailing Address - Country:US
Mailing Address - Phone:508-477-1802
Mailing Address - Fax:508-539-3713
Practice Address - Street 1:681 FALMOUTH RD
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3327
Practice Address - Country:US
Practice Address - Phone:508-477-1802
Practice Address - Fax:508-539-3713
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2864152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA454369OtherU S FAMILY HEALTH
MA454369OtherAETNA
MAS012088OtherTRICARE/CHAMPUS
MA6895447 001OtherCIGNA
MAW15619OtherBCBS
MA0352446Medicaid
MA15391OtherHARVARD PILGRIM
MA723151OtherTUFTS
MA2200561OtherUNITED HEALTH CARE
MA454369OtherAETNA
MA6895447 001OtherCIGNA