Provider Demographics
NPI:1588011985
Name:LAM, PHILIP (DO)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2800 E AJO WAY
Mailing Address - Street 2:PSYCHIATRY RESIDENCY
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-6204
Mailing Address - Country:US
Mailing Address - Phone:520-874-4501
Mailing Address - Fax:520-694-0503
Practice Address - Street 1:2800 E AJO WAY
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6204
Practice Address - Country:US
Practice Address - Phone:520-694-1234
Practice Address - Fax:520-874-7539
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ0084832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry