Provider Demographics
NPI:1013193077
Name:LAMBERT, KLAMER AND GUPTA, PSC
Entity Type:Organization
Organization Name:LAMBERT, KLAMER AND GUPTA, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:KLAMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-897-0635
Mailing Address - Street 1:3991 DUTCHMANS LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4700
Mailing Address - Country:US
Mailing Address - Phone:502-897-0635
Mailing Address - Fax:502-895-3219
Practice Address - Street 1:3991 DUTCHMANS LN
Practice Address - Street 2:SUITE 103
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4700
Practice Address - Country:US
Practice Address - Phone:502-897-0635
Practice Address - Fax:502-895-3219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCB5775OtherRAILROAD MEDICARE
KY65906190Medicaid
KY2432212000OtherPASSPORT ADVANTAGE
KY1048782OtherPASSPORT HEALTH PLAN
KY0970Medicare PIN