MEDICARE: DR. JAMIE J CASPER O.D., PHD, FAAO

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
1	152W00000X	Optometrist	5463	OH
2	152WP0200X	Pediatric Optometrist	1946	NC
3	152WC0802X	Corneal and Contact Management Optometrist	1946	NC
4	152W00000X	Optometrist	1946	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932103439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMIE J CASPER O.D., PHD, FAAO

Provider Business Mailing Address
First Line	:	5526 CAROLINA BEACH RD
Second Line	:	SUITE B
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2606
Country	:	US
Telephone Number	:	910-452-7225
Fax Number	:	910-452-7229

Provider Business Practice Location Address
First Line	:	5526 CAROLINA BEACH RD
Second Line	:	SUITE B
City	:	WILMINGTON
State	:	NC
Zip	:	28412-2606
Country	:	US
Telephone Number	:	910-452-7225
Fax Number	:	910-452-7229

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	09/13/2010

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