Provider Demographics
NPI:1952402182
Name:DUNLAP, JANICE B (OD)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:B
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1249
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28002-1249
Mailing Address - Country:US
Mailing Address - Phone:704-982-6011
Mailing Address - Fax:704-982-1106
Practice Address - Street 1:303 SALISBURY AVE
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-1249
Practice Address - Country:US
Practice Address - Phone:704-982-6011
Practice Address - Fax:704-982-1106
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC 1185152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0558150001OtherPALMETTO
NC410003847OtherRAILROAD MEDICARE
NC09229OtherNC HEALTH CHOICE
NC8909229Medicaid
NC09229OtherBCBS OF NC
NC6471359001OtherCIGNA
NC410003847OtherRAILROAD MEDICARE
NC09229OtherBCBS OF NC
NC09229OtherNC HEALTH CHOICE