Provider Demographics
NPI:1861429920
Name:LAMPARD, WILLIAM WALTER (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WALTER
Last Name:LAMPARD
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 1:1609 SE PORT ST LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5428
Mailing Address - Country:US
Mailing Address - Phone:772-398-0067
Mailing Address - Fax:772-398-0069
Practice Address - Street 1:1609 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5428
Practice Address - Country:US
Practice Address - Phone:772-398-0067
Practice Address - Fax:772-398-0067
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 92217207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine