1003907726 NPI number — LAMBERT EYECARE ASSOCIATES PSC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003907726 NPI number — LAMBERT EYECARE ASSOCIATES PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAMBERT EYECARE ASSOCIATES PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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 Information

NPI Number:
1003907726
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 169
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FOREST HILLS
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41527-0169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-237-7196
Provider Business Mailing Address Fax Number:
606-237-7205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28531 US HIGHWAY 119
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH WILLIAMSON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41503-3928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-237-7196
Provider Business Practice Location Address Fax Number:
606-237-7205
Provider Enumeration Date:
09/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LAMBERT
Authorized Official First Name:
DON
Authorized Official Middle Name:
HENRY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
606-237-7196

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 77901676 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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