Provider Demographics
NPI:1528329539
Name:LAMOUR, JACQUES PHILIPPE (MD)
Entity type:Individual
Prefix:DR
First Name:JACQUES
Middle Name:PHILIPPE
Last Name:LAMOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 VISTA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-5641
Mailing Address - Country:US
Mailing Address - Phone:863-370-2631
Mailing Address - Fax:
Practice Address - Street 1:13619 SE HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-7861
Practice Address - Country:US
Practice Address - Phone:863-491-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 77697207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine