Provider Demographics
NPI:1245207513
Name:LAMBIASE, LOUIS ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:ROBERT
Last Name:LAMBIASE
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 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:2055 E SOUTH BLVD STE 202
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2002
Practice Address - Country:US
Practice Address - Phone:334-747-7575
Practice Address - Fax:334-747-7590
Is Sole Proprietor?:No
Enumeration Date:2006-03-04
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44678207R00000X, 207RG0100X
AL42770207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000811775AMedicaid
FL2547066-00Medicaid
FLF04300Medicare UPIN
FL14244YMedicare PIN
FL100011746OtherRAILROAD MEDICARE