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NPI Code Detail

MEDICARE: MR. JARRED S LAMPERT PA

MEDICARE:  MR. JARRED S LAMPERT  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant1001300AIN

General Provider Information

NPI Number : 1790073336
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JARRED S LAMPERT PA
Provider Business Mailing Address
First Line : PO BOX 1028
Second Line :
City : JASPER
State : IN
Zip : 47547-1028
Country : US
Telephone Number : 812-996-0410
Fax Number : 812-996-8497
Provider Business Practice Location Address
First Line : 695 W 2ND ST
Second Line : SUITE A2
City : JASPER
State : IN
Zip : 47546-3240
Country : US
Telephone Number : 812-996-6500
Fax Number : 812-996-6502
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2011
Last Update Date : 04/23/2014

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Directions to “ MR. JARRED S LAMPERT PA” Practice Location

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