Provider Demographics
NPI:1013073691
Name:LANHAM, REBECCA HOPE (OD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:HOPE
Last Name:LANHAM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 MEIJER WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3340
Mailing Address - Country:US
Mailing Address - Phone:859-278-0055
Mailing Address - Fax:859-277-4490
Practice Address - Street 1:340 MEIJER WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3340
Practice Address - Country:US
Practice Address - Phone:859-278-0055
Practice Address - Fax:859-277-4490
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1456 DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0778802 PINMedicare ID - Type Unspecified
KYV06893Medicare UPIN