Provider Demographics
NPI:1558331645
Name:LAM, FRANK Y (OD)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:Y
Last Name:LAM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-6009
Mailing Address - Country:US
Mailing Address - Phone:541-850-5253
Mailing Address - Fax:541-880-5595
Practice Address - Street 1:705 MAIN ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-6009
Practice Address - Country:US
Practice Address - Phone:541-850-5253
Practice Address - Fax:541-880-5595
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2516T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR079582Medicaid
OR079582Medicaid
ORR101075Medicare ID - Type Unspecified
OR5006290001Medicare NSC