=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578968962
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICK D LAMB MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2014
-----------------------------------------------------
Last Update Date | 10/27/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3824 CEDAR SPRINGS RD # 801-3443
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75219-4136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-278-6490
-----------------------------------------------------
Fax | 406-403-0411
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3824 CEDAR SPRINGS RD # 801-3443
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75219-4136
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-278-6490
-----------------------------------------------------
Fax | 406-403-0411
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207PE0004X
-----------------------------------------------------
Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
-----------------------------------------------------
License Number | 5230
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------