Provider Demographics
NPI:1306167838
Name:MECHAM, AMASA L (OD)
Entity type:Individual
Prefix:DR
First Name:AMASA
Middle Name:L
Last Name:MECHAM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 FALL VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-5401
Mailing Address - Country:US
Mailing Address - Phone:803-636-6450
Mailing Address - Fax:
Practice Address - Street 1:201 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5782
Practice Address - Country:US
Practice Address - Phone:803-636-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007647-1152W00000X
WY456152W00000X
TX7571 T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist