Healthcare Provider Details

I. General information

NPI: 1639192974
Provider Name (Legal Business Name): WILLIAM CLARK LAMBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W WATER ST
TOMS RIVER NJ
08753-6407
US

IV. Provider business mailing address

PO BOX 5191
TOMS RIVER NJ
08754-5191
US

V. Phone/Fax

Practice location:
  • Phone: 732-244-4700
  • Fax: 732-244-8482
Mailing address:
  • Phone: 732-244-4700
  • Fax: 732-244-8482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number25MA03110800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number25MA03110800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA03110800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: