Provider Demographics
NPI:1356313399
Name:LAMBERT, DONALD J (PAC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-2545
Mailing Address - Country:US
Mailing Address - Phone:717-721-4585
Mailing Address - Fax:717-721-4597
Practice Address - Street 1:895 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-2545
Practice Address - Country:US
Practice Address - Phone:717-721-4585
Practice Address - Fax:717-721-4597
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001678L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
R05384Medicare UPIN
PA054856Medicare ID - Type Unspecified