Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 16735 | GA |
NPI | 1043446727 |
---|---|
Provider Name | Dr. Gail Little Lamb |
First Address | Tybee Island, GA 31328 |
Second Address | Tybee Island, GA 31328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 08/06/2009 |