Provider Demographics
NPI:1336490143
Name:LAMPERT, RONALD MARVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:MARVIN
Last Name:LAMPERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1365 S. HIGH VALLEY RANCH ROAD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:96303
Mailing Address - Country:US
Mailing Address - Phone:602-870-3355
Mailing Address - Fax:602-870-3044
Practice Address - Street 1:11811 N.N. TATUM BLVD.
Practice Address - Street 2:SUITE 3031
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-1621
Practice Address - Country:US
Practice Address - Phone:602-870-3355
Practice Address - Fax:602-870-3044
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ17314202C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner