1790977817 NPI number — A LAMBERSON, M.D., LLC

Table of content: (NPI 1790977817)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790977817 NPI number — A LAMBERSON, M.D., LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A LAMBERSON, M.D., LLC
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:
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:
1790977817
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
198 NARROWS DR
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35242-8662
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-981-2124
Provider Business Mailing Address Fax Number:
205-981-2134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
198 NARROWS DR
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35242-8662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-981-2124
Provider Business Practice Location Address Fax Number:
205-981-2134
Provider Enumeration Date:
08/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LAMBERSON
Authorized Official First Name:
ANDREA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
205-981-2124

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  15962 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 09637 . This is a "BLUE CROSS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 009915615 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com