1679539738 NPI number — EDWARD W LAMPTON JR. M.D.

Table of content: EDWARD W LAMPTON JR. M.D. (NPI 1679539738)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679539738 NPI number — EDWARD W LAMPTON JR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMPTON
Provider First Name:
EDWARD
Provider Middle Name:
W
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1679539738
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 PENNCRAFT AVE
Provider Second Line Business Mailing Address:
SUITE E
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-5600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-263-1383
Provider Business Mailing Address Fax Number:
171-263-7434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 PENNCRAFT AVE
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-5600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-263-1383
Provider Business Practice Location Address Fax Number:
171-263-7434
Provider Enumeration Date:
04/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MC041903E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0007661630002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50015118 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02662375 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 313041001 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: LA140145 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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