Provider Demographics
NPI:1699350264
Name:SEGO FAMILY MEDICINE, PLLC
Entity type:Organization
Organization Name:SEGO FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-375-6473
Mailing Address - Street 1:2023 ZUNI TRL
Mailing Address - Street 2:
Mailing Address - City:BAR NUNN
Mailing Address - State:WY
Mailing Address - Zip Code:82601-6463
Mailing Address - Country:US
Mailing Address - Phone:425-375-6473
Mailing Address - Fax:
Practice Address - Street 1:423 N OREM BLVD
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-8813
Practice Address - Country:US
Practice Address - Phone:801-426-8141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty