=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518302017
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN RICHARD LAMM JR. M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2013
-----------------------------------------------------
Last Update Date | 06/03/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 ROSE ST MS101
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40536-0298
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-323-6263
-----------------------------------------------------
Fax | 859-323-1127
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 856 J CLYDE MORRIS BLVD STE A
-----------------------------------------------------
City | NEWPORT NEWS
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23601-1318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-316-5800
-----------------------------------------------------
Fax | 757-534-5190
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207T00000X
-----------------------------------------------------
Taxonomy Name | Neurological Surgery Physician
-----------------------------------------------------
License Number | R3256
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207T00000X
-----------------------------------------------------
Taxonomy Name | Neurological Surgery Physician
-----------------------------------------------------
License Number | 0101268724
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------