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General NPI Number Information
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NPI Number | 1366791675
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Entity Type | Individual
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Provider Name | JOEL ALLEN LAMBOTTE PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/31/2012
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 4235 N SAINT JAMES PL
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City | BEL AIRE
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State | KS
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Zip | 67226-1404
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Country | US
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Telephone | 316-259-1516
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Fax |
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Provider Business Mailing Address
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Address Line | 4235 N SAINT JAMES PL
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City | BEL AIRE
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State | KS
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Zip | 67226-1404
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Country | US
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Telephone | 316-259-1516
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 8414359-1206
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C05249
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1501666
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License Number State | KS
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