Healthcare Provider Details

I. General information

NPI: 1497335145
Provider Name (Legal Business Name): TRAVIS LAMBERT II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 NORTH BLVD STE 200
BATON ROUGE LA
70806-3743
US

IV. Provider business mailing address

1710 BRIGHTSIDE DR APT D
BATON ROUGE LA
70820-1720
US

V. Phone/Fax

Practice location:
  • Phone: 225-381-6620
  • Fax:
Mailing address:
  • Phone: 337-802-1257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberW5422
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: