Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | K4319 | TX |
NPI | 1376500553 |
---|---|
Provider Name | Dr. Jeffrey Paul Lamont |
First Address | Dallas, TX 75391-1230 |
Second Address | Dallas, TX 75246-2003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2006 |
Last Update Date | 09/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100753280E | OKLAHOMA MEDICAID (01) | OK |
161714403 | (05) | TX |
P00840659 | RAILROAD MEDICARE (01) | TX |