Basic Information
| Provider Information | |||||||||
| NPI: | 1194080119 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALECIA BARNES, OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9640 CLUBVALLEY WAY | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276178604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196498858 | ||||||||
| FaxNumber: | 9198821204 | ||||||||
| Practice Location | |||||||||
| Address1: | 1002 N SPENCE AVE | ||||||||
| Address2: | |||||||||
| City: | GOLDSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275344270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198810900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2012 | ||||||||
| LastUpdateDate: | 07/20/2012 | ||||||||
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| AuthorizedOfficialLastName: | BARNES | ||||||||
| AuthorizedOfficialFirstName: | ALECIA | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9198810900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1644 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.