=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760524201
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GARLAND ROBERTS LEHMAN O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2007
-----------------------------------------------------
Last Update Date | 09/16/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 141 PARAGON PKWY
-----------------------------------------------------
City | CLYDE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28721-9481
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-452-1436
-----------------------------------------------------
Fax | 828-452-1434
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 135 TOWN CENTER LOOP
-----------------------------------------------------
City | WAYNESVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28786-6871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-452-1436
-----------------------------------------------------
Fax | 828-452-1434
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 1166
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------