DR. Lance William Fagan, O.D.

NPI #1891775151 in Coeur D Alene, Idaho

Provider Information

NPI Number: 1891775151
Entity Type: Individual
Name: DR. Lance William Fagan, O.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Jan 20, 2006
Last Updated: Apr 12, 2011

Practice Location

Address: 1801 N 3RD ST
City: Coeur D Alene
State: Idaho
ZIP Code: 83814-3400
Phone: (208) 667-1591

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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