Provider Demographics
NPI:1174845366
Name:LAMB, JOSEPH A (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:LAMB
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 575
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1476
Mailing Address - Country:US
Mailing Address - Phone:404-350-0106
Mailing Address - Fax:404-350-0176
Practice Address - Street 1:2001 PEACHTREE RD NE
Practice Address - Street 2:SUITE 575
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1476
Practice Address - Country:US
Practice Address - Phone:404-350-0106
Practice Address - Fax:404-350-0176
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005768363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20297I7702OtherMEDICARE PTAN
GA005768OtherGA LICENSE
GA005768OtherGA LICENSE