Provider Demographics
NPI:1427449933
Name:ROGER D LAMPKIN JR
Entity type:Organization
Organization Name:ROGER D LAMPKIN JR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-382-3112
Mailing Address - Street 1:908 S 12TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2949
Mailing Address - Country:US
Mailing Address - Phone:270-753-0666
Mailing Address - Fax:270-753-0684
Practice Address - Street 1:908 S 12TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2949
Practice Address - Country:US
Practice Address - Phone:270-753-0666
Practice Address - Fax:270-753-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty