Healthcare Provider Details

I. General information

NPI: 1225171648
Provider Name (Legal Business Name): BENJAMIN A LAMPERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 E PORTLAND ST
SPRINGFIELD MO
65804-1311
US

IV. Provider business mailing address

PO BOX 2580
SPRINGFIELD MO
65801-2580
US

V. Phone/Fax

Practice location:
  • Phone: 417-820-6850
  • Fax:
Mailing address:
  • Phone: 417-829-4620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberR4E34
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: