Healthcare Provider Details

I. General information

NPI: 1437337391
Provider Name (Legal Business Name): JOHN MICHAEL LAMBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2008
Last Update Date: 08/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAJO ROUTE N12 AND N7 FDIH TSEHOOTSOOI MEDICAL CENTER NAVAJO NATION
FORT DEFIANCE AZ
86504
US

IV. Provider business mailing address

926 47TH ST APT. #1C
BROOKLYN NY
11219-2861
US

V. Phone/Fax

Practice location:
  • Phone: 928-729-8000
  • Fax: 928-729-8269
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7754413-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: