Provider Demographics
NPI:1003930157
Name:DRS. NAULTY & LAMPKIN
Entity Type:Organization
Organization Name:DRS. NAULTY & LAMPKIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAULTY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:270-753-0666
Mailing Address - Street 1:908 S 12TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2949
Mailing Address - Country:US
Mailing Address - Phone:270-753-0666
Mailing Address - Fax:270-753-0684
Practice Address - Street 1:815 BIRCH ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-1337
Practice Address - Country:US
Practice Address - Phone:270-527-7014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00160213E00000X
KY00244213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY80002447Medicaid
KY000000052091OtherBLUE SHIELD PIN
KY80001605Medicaid
KY000000052090OtherBLUE SHIELD PIN