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General NPI Number Information
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NPI Number | 1295465391
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Entity Type | Individual
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Provider Name | AUGUSTUS WALTER LAMB MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2022
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 929 N SAINT FRANCIS AVE # 3082
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City | WICHITA
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State | KS
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Zip | 67214-3821
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Country | US
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Telephone | 316-268-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 6215 E OXFORD ST
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City | WICHITA
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State | KS
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Zip | 67220-5522
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Country | US
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Telephone | 785-846-8008
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 94-11061
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License Number State | KS
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