Healthcare Provider Details

I. General information

NPI: 1558373126
Provider Name (Legal Business Name): DAVID J LAMPERT NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 NW GARDEN VALLEY BLVD BLUE CLINIC
ROSEBURG OR
97470-6523
US

IV. Provider business mailing address

1356 ECHO DR
ROSEBURG OR
97470-8481
US

V. Phone/Fax

Practice location:
  • Phone: 541-440-1000
  • Fax: 541-440-1343
Mailing address:
  • Phone: 541-440-1000
  • Fax: 541-440-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: