1760473383 NPI number — RICHARD LAMPE M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760473383 NPI number — RICHARD LAMPE M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

LAMPE

Provider First Name:

RICHARD

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1760473383

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

08/07/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

2211 LOMAS BLVD NE

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ALBUQUERQUE

Provider Business Mailing Address State Name:

NM

Provider Business Mailing Address Postal Code:

87106-2719

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

806-743-2787

Provider First Line Business Practice Location Address:

2211 LOMAS BLVD NE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

ALBUQUERQUE

Provider Business Practice Location Address State Name:

NM

Provider Business Practice Location Address Postal Code:

87106-2719

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

806-787-0224

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

11/02/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208000000X , with the licence number:  J2653 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2080P0208X , with the licence number: J2653 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208000000X , with the licence number: MD2022-1390 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 100065540A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
• Identifier: 137934908 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 52493 . This is a "PRESBYTERIAN COMMERCIAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: A103 . This is a "TRIWEST" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
• Identifier: 117315104 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 52493 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: 86K886 . This is a "BC/BS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: H1713 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
• Identifier: 117315101 . This is a "FIRSTCARE COMMERCIAL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
• Identifier: 137934905 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
• Identifier: 80823Z . This is a "HMO BLUE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".