Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 00244 | KY |
Y | 222Z00000X | Podiatrist | 00244 | KY |
NPI | 1053423459 |
---|---|
Provider Name | Dr. Roger D Lampkin JR. |
First Address | Murray, KY 42071-2949 |
Second Address | Murray, KY 42071-2949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 06/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000052091 | BLUE SHIELD (01) | KY |
80002447 | (05) | KY |
90005646 | (05) | KY |
U71529 | (02) | KY |