Provider Demographics
NPI:1265038335
Name:LAMM, GREGORY DAVID (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DAVID
Last Name:LAMM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 LONE OAK RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-4538
Mailing Address - Country:US
Mailing Address - Phone:270-994-1076
Mailing Address - Fax:
Practice Address - Street 1:538 LONE OAK RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-4538
Practice Address - Country:US
Practice Address - Phone:270-994-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008417183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist