Provider Demographics
NPI:1750073698
Name:BARNETT, PAIGE (LDO)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 CRITCHER FARM LN
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:NC
Mailing Address - Zip Code:27504-6575
Mailing Address - Country:US
Mailing Address - Phone:919-292-4754
Mailing Address - Fax:
Practice Address - Street 1:8000 TOWN DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-2828
Practice Address - Country:US
Practice Address - Phone:919-424-6609
Practice Address - Fax:919-431-9640
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2208156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician