Provider Demographics
NPI:1295828614
Name:LAMPTON, BRETT C (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:C
Last Name:LAMPTON
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:PO BOX 71807
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23255-1807
Mailing Address - Country:US
Mailing Address - Phone:877-794-2284
Mailing Address - Fax:804-612-5201
Practice Address - Street 1:1100 BELK BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5242
Practice Address - Country:US
Practice Address - Phone:662-832-4003
Practice Address - Fax:804-612-5201
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13188208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1295828614Medicaid
MSF30880Medicare UPIN
F30880Medicare UPIN
MS64-0855416OtherEMPLOYER ID#
MS110001428Medicare ID - Type UnspecifiedMEDICARE #
MS110219457Medicare PIN
MS00112121Medicaid
MSF30880Medicare UPIN