Healthcare Provider Details

I. General information

NPI: 1689651390
Provider Name (Legal Business Name): KATHLEEN E LAMBERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2005
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 MILSTEAD RD NE STE 110
CONYERS GA
30012-3849
US

IV. Provider business mailing address

1835 SAVOY DR SUITE 300
ATLANTA GA
30341-1072
US

V. Phone/Fax

Practice location:
  • Phone: 770-760-9949
  • Fax: 770-760-9951
Mailing address:
  • Phone: 770-760-9949
  • Fax: 770-760-9951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number070216
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: