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NPI Code Detail

MEDICARE: DR. ERIC W LAMP O.D.

MEDICARE: DR. ERIC W LAMP O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist1379-3KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1005347OTHERKSBCBS

General Provider Information

NPI Number : 1285605618
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERIC W LAMP O.D.
Provider Business Mailing Address
First Line : 1202 W MAPLE ST
Second Line :
City : WICHITA
State : KS
Zip : 67213-3916
Country : US
Telephone Number : 316-262-3716
Fax Number : 316-262-0784
Provider Business Practice Location Address
First Line : 1202 W MAPLE ST
Second Line :
City : WICHITA
State : KS
Zip : 67213-3916
Country : US
Telephone Number : 316-262-3716
Fax Number : 316-262-0784
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 08/12/2008

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Directions to “ DR. ERIC W LAMP O.D.” Practice Location

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