Provider Demographics
NPI:1194245712
Name:CLINARD, CAMERON WATERS (OD)
Entity type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:WATERS
Last Name:CLINARD
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:CAMERON
Other - Middle Name:BLAKE
Other - Last Name:WATERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3510 AIR PARK RD
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-9464
Mailing Address - Country:US
Mailing Address - Phone:252-721-1948
Mailing Address - Fax:
Practice Address - Street 1:1340 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-2617
Practice Address - Country:US
Practice Address - Phone:919-552-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-24
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2486152W00000X
TN3398152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist