Provider Demographics
NPI:1851541577
Name:RAOY D LAMB OD
Entity Type:Organization
Organization Name:RAOY D LAMB OD
Other - Org Name:ADVANCED FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:334-566-5658
Mailing Address - Street 1:502 N THREE NOTCH ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081
Mailing Address - Country:US
Mailing Address - Phone:334-566-5658
Mailing Address - Fax:334-566-1031
Practice Address - Street 1:502 N THREE NOTCH ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36081
Practice Address - Country:US
Practice Address - Phone:334-566-5658
Practice Address - Fax:334-566-1031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5318TA225152W00000X
AL5319TA226152W00000X
ALSB81TA793152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
51059170OtherBCBS
AL000059170Medicaid
51059170OtherBCBS