Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 40837 | GA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 040837 | GA |
NPI | 1033112040 |
---|---|
Provider Name | Dr. Keith A. Lamberson |
First Address | Atlanta, GA 30339-3035 |
Second Address | Austell, GA 30106-6821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 14/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00884089A | (05) | GA |
H07087 | (02) | |
H07087 | (02) | GA |