Samuel Fam, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

12430R Issued in LA

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(318) 680-6607

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1598875544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31294",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370400022",
            "telephone_number": "318-680-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "318-680-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAM",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "34678",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "12430R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Newell Christopher Eslinger Jr., PA-C
• April M Evans, ATC
• Iris K Evans, CNM
• Ross Aaron Everhard, PSYD
• Erica Michelle Fallon, PT, DPT
• Sherry L Fanara
• John Paul Fanning, D.O.
• Thomas Robert Fanning, PSY.D.
• Travis V Farhar, PA-C
• Kason James Fark, PARAMEDIC

• Psychiatry Physician in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.