Provider Demographics
NPI:1629561204
Name:LAPPIN, CORY JAMES (OD)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:JAMES
Last Name:LAPPIN
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 1:3805 E BELL RD STE 1800
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2135
Mailing Address - Country:US
Mailing Address - Phone:602-549-2020
Mailing Address - Fax:
Practice Address - Street 1:3805 E BELL RD STE 1800
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2135
Practice Address - Country:US
Practice Address - Phone:602-549-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006652152W00000X
AZOPT-002372152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist