1750602595 NPI number — LAMBERT CHIROPRACTIC AND WELLNESS CENTER PC

Table of content: DR. HYMAN WENDELL FISHER M.D. (NPI 1851317606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750602595 NPI number — LAMBERT CHIROPRACTIC AND WELLNESS CENTER PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAMBERT CHIROPRACTIC AND WELLNESS CENTER PC
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:
1750602595
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5353 FAIRINGTON RD STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITHONIA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30038-1164
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-987-0771
Provider Business Mailing Address Fax Number:
770-987-0737

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5353 FAIRINGTON RD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITHONIA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30038-1164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-987-0771
Provider Business Practice Location Address Fax Number:
770-987-0737
Provider Enumeration Date:
06/16/2010

Additional Information

Authorized Official

Authorized Official Last Name:
LAMBERT
Authorized Official First Name:
SECORA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/DR OF CHIROPRACTIC
Authorized Official Telephone Number:
770-987-0771

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CHIRO007799 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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