Individual
DR. JONATHAN DEAN FAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2640 BIEHN ST STE 3, KLAMATH FALLS, OR 97601-1181
(541) 884-3148
(541) 884-3373
Mailing address
2640 BIEHN ST., STE 3, KLAMATH FALLS, OR 97601-1181
(541) 884-3148
(541) 884-3373
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
283073
NY
207W00000X
Ophthalmology Physician
Primary
MD181538
OR
207WX0120X
Cornea and External Diseases Specialist Physician
MD181538
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500725690
—
OR
05
—
MEDICAID
—
NY
Enumeration date
06/12/2012
Last updated
10/22/2020
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