Healthcare Provider Details

I. General information

NPI: 1720052236
Provider Name (Legal Business Name): SCOTT J LAMBERT MBA, ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E PARKWAY S BOX T-1
MEMPHIS TN
38104-5519
US

IV. Provider business mailing address

7119 PARKBROOK LN
CORDOVA TN
38018-7933
US

V. Phone/Fax

Practice location:
  • Phone: 901-321-3263
  • Fax: 901-321-3570
Mailing address:
  • Phone: 901-213-3478
  • Fax: 901-321-3570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: