Organization
KLAMATH OPHTHALMOLOGY, PC
Active
Other names
Lakeview Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK T FAY MD (OWNER/PRESIDENT)
(541) 884-3148
Entity
Organization
Contact information
Practice address
628 N 1ST ST, SUITE C, LAKEVIEW, OR 97630-1506
(541) 947-3357
(541) 947-3368
Mailing address
2640 BIEHN ST, SUITE 3, KLAMATH FALLS, OR 97601-1181
(541) 884-3148
(541) 884-3373
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2599ATI
OR
207W00000X
Ophthalmology Physician
MD16253
OR
207W00000X
Ophthalmology Physician
MD29440
OR
Other
Enumeration date
12/03/2014
Last updated
01/06/2015
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