Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | MD.33417 | AL |
N | 207Q00000X | Family Doctor | MD.33147 | AL |
Y | 207Q00000X | Family Doctor | ME100212 | FL |
NPI | 1194847699 |
---|---|
Provider Name | Dr. Jon Patrick Lamb |
First Address | Sopchoppy, FL 32358-1023 |
Second Address | Geneva, AL 36340-1642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 29/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
281056500 | (05) | FL |