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General NPI Number Information
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NPI Number | 1184913022
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Entity Type | Individual
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Provider Name | BRIAN LAM PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 07/10/2015
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Provider Practice Location Address
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Address Line | 1211 UNION AVE SUITE 300
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City | MEMPHIS
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State | TN
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Zip | 38104-6638
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Country | US
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Telephone | 901-609-3520
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Fax | 901-266-6451
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Provider Business Mailing Address
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Address Line | PO BOX 1000 DEPT # 457
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City | MEMPHIS
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State | TN
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Zip | 38148-0001
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Country | US
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Telephone | 901-486-8811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1958
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License Number State | TN
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