Healthcare Provider Details

I. General information

NPI: 1629364492
Provider Name (Legal Business Name): JOHN S. LAMBERT, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3443 HARRISON ST
BATESVILLE AR
72501-8820
US

IV. Provider business mailing address

3443 HARRISON ST
BATESVILLE AR
72501-8820
US

V. Phone/Fax

Practice location:
  • Phone: 870-793-4445
  • Fax: 870-698-8844
Mailing address:
  • Phone: 870-793-4445
  • Fax: 870-698-8844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-427
License Number StateAR

VIII. Authorized Official

Name: JOHN S. LAMBERT
Title or Position: OWNER
Credential: M.D.
Phone: 870-793-4445