Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 1-049866 | AL |
NPI | 1154302792 |
---|---|
Provider Name | Mrs. Ann W. Lambert |
First Address | Brewton, AL 36426-1304 |
Second Address | Brewton, AL 36426-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 29/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51511894LAM | BCBS OF ALABAMA (01) | AL |
78307 | (02) | AL |
891003040 | (05) | AL |