Provider Demographics
NPI:1487900783
Name:GREGORY A. LAMBE, D.C., P.A.
Entity type:Organization
Organization Name:GREGORY A. LAMBE, D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAMBE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:850-482-2966
Mailing Address - Street 1:3894 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-8919
Mailing Address - Country:US
Mailing Address - Phone:850-482-2966
Mailing Address - Fax:850-526-2994
Practice Address - Street 1:3894 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-8919
Practice Address - Country:US
Practice Address - Phone:850-482-2966
Practice Address - Fax:850-526-2994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004466261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88071OtherMEDICARE PROVIDER # 88071
FLU08609Medicare UPIN