=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013193077
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LAMBERT, KLAMER AND GUPTA, PSC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/21/2008
-----------------------------------------------------
Last Update Date | 01/21/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3991 DUTCHMANS LN SUITE 103
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40207-4700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-897-0635
-----------------------------------------------------
Fax | 502-895-3219
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3991 DUTCHMANS LN SUITE 103
-----------------------------------------------------
City | LOUISVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40207-4700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 502-897-0635
-----------------------------------------------------
Fax | 502-895-3219
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | DR. THOMAS W KLAMER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 502-897-0635
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------