Healthcare Provider Details

I. General information

NPI: 1417259847
Provider Name (Legal Business Name): MR. THOMAS E LAMBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2010
Last Update Date: 11/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11205 ALPHARETTA HWY E-3
ROSWELL GA
30076-5610
US

IV. Provider business mailing address

11205 ALPHARETTA HWY E-3
ROSWELL GA
30076
US

V. Phone/Fax

Practice location:
  • Phone: 678-240-0042
  • Fax:
Mailing address:
  • Phone: 678-240-0042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: