Provider Demographics
NPI:1649241241
Name:LAMKIN, JEFFREY C (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C
Last Name:LAMKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6480 MAIN STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5852
Mailing Address - Country:US
Mailing Address - Phone:716-631-3300
Mailing Address - Fax:716-631-3303
Practice Address - Street 1:6480 MAIN STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-631-3300
Practice Address - Fax:716-631-3303
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282254207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0966147Medicaid
E87179Medicare UPIN
4063786Medicare ID - Type Unspecified9480 ROSEMONT DR
4063788Medicare ID - Type Unspecified650 GRAHAM ROAD
4063789Medicare ID - Type Unspecified3591 RESERVE COMMONS DR
4063784Medicare ID - Type Unspecified75 ARCH STREET, STE 302
0738065Medicare ID - Type Unspecified
4063787Medicare ID - Type Unspecified2013 STATE ROUTE 59
OH0966147Medicaid