Provider Demographics
NPI:1154300184
Name:LAMMERS, SAMUEL PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:PAUL
Last Name:LAMMERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 HWY 71 NORTH
Mailing Address - Street 2:PO BOX 965
Mailing Address - City:OKOBOJI
Mailing Address - State:IA
Mailing Address - Zip Code:51355-2536
Mailing Address - Country:US
Mailing Address - Phone:712-332-7775
Mailing Address - Fax:712-332-7772
Practice Address - Street 1:1799 HIGHWAY 71 N
Practice Address - Street 2:
Practice Address - City:OKOBOJI
Practice Address - State:IA
Practice Address - Zip Code:51355-2536
Practice Address - Country:US
Practice Address - Phone:712-332-7775
Practice Address - Fax:712-332-7772
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA06143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0460345Medicaid
U79486Medicare UPIN
IA0460345Medicaid
IAI15848Medicare PIN