Healthcare Provider Details

I. General information

NPI: 1750177804
Provider Name (Legal Business Name): JAMIE BARBER ABO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 JOSLYN RD
AUBURN HILLS MI
48326-1329
US

IV. Provider business mailing address

4350 JOSLYN RD
AUBURN HILLS MI
48326-1329
US

V. Phone/Fax

Practice location:
  • Phone: 248-391-0508
  • Fax: 248-391-0599
Mailing address:
  • Phone: 248-391-0508
  • Fax: 248-391-0599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: