Provider Demographics
NPI:1588711303
Name:LAMBETH, JOHN PHILLIP (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PHILLIP
Last Name:LAMBETH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-992-1351
Mailing Address - Fax:336-992-1361
Practice Address - Street 1:500 PINEVIEW DR
Practice Address - Street 2:SUITE 101
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-3812
Practice Address - Country:US
Practice Address - Phone:336-992-1351
Practice Address - Fax:336-992-1361
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2024-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2009-01242207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917807Medicaid
NCNC2389AMedicare PIN