Provider Demographics
NPI:1447784582
Name:WAMPLER, CARA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:CARA
Middle Name:MARIE
Last Name:WAMPLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:CARA
Other - Middle Name:MARIE
Other - Last Name:EBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:430 ARLINGTON RD STE B
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45309-1103
Mailing Address - Country:US
Mailing Address - Phone:937-770-1265
Mailing Address - Fax:
Practice Address - Street 1:430 ARLINGTON RD STE B
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:OH
Practice Address - Zip Code:45309
Practice Address - Country:US
Practice Address - Phone:937-770-1265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-15
Last Update Date:2019-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOPT-002256152W00000X
390200000X
OH6544152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty