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NPI Code Detail

MEDICARE: DR. CAROL PAIGE BRINGHAM O.D.

MEDICARE:  DR. CAROL PAIGE BRINGHAM  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist659HI
2152W00000XOptometrist0618002076VA

General Provider Information

NPI Number : 1407015274
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROL PAIGE BRINGHAM O.D.
Provider Business Mailing Address
First Line : 4018 CAMPBELL AVE
Second Line :
City : ARLINGTON
State : VA
Zip : 22206-3424
Country : US
Telephone Number : 703-671-1188
Fax Number : 703-671-1198
Provider Business Practice Location Address
First Line : 4018 CAMPBELL AVE
Second Line :
City : ARLINGTON
State : VA
Zip : 22206-3424
Country : US
Telephone Number : 703-671-1188
Fax Number : 703-671-1198
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2008
Last Update Date : 03/18/2019

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Directions to “ DR. CAROL PAIGE BRINGHAM O.D.” Practice Location

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