Provider Demographics
NPI:1013019033
Name:LAMON, JAMES CLYDE (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CLYDE
Last Name:LAMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SUNSET CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MOULTRIE
Mailing Address - State:GA
Mailing Address - Zip Code:31768
Mailing Address - Country:US
Mailing Address - Phone:229-985-5200
Mailing Address - Fax:229-985-1302
Practice Address - Street 1:320 SUNSET CIRCLE
Practice Address - Street 2:
Practice Address - City:MOULTRIE
Practice Address - State:GA
Practice Address - Zip Code:31768
Practice Address - Country:US
Practice Address - Phone:229-985-5200
Practice Address - Fax:229-985-1302
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA21172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00220349CMedicaid
D70522Medicare UPIN