1700896255 NPI number — MR. DAVID P LAMB RPH

Table of content: MR. DAVID P LAMB RPH (NPI 1700896255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700896255 NPI number — MR. DAVID P LAMB RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMB
Provider First Name:
DAVID
Provider Middle Name:
P
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
RPH
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:
1700896255
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:
1101 N COUNTY ROAD 19
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BERTHOUD
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80513-9321
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
970-461-1975
Provider Business Mailing Address Fax Number:
970-461-4042

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
653 DENVER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOVELAND
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80537-5128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
970-461-1975
Provider Business Practice Location Address Fax Number:
970-461-4042
Provider Enumeration Date:
08/08/2006

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: 183500000X , with the licence number:  10958 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10958 . This is a "COLORADO STATE LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com