Provider Demographics
NPI:1376684993
Name:LAMKIN, EUGENE HENRY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:HENRY
Last Name:LAMKIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4145 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-2616
Mailing Address - Country:US
Mailing Address - Phone:317-283-2780
Mailing Address - Fax:317-283-4508
Practice Address - Street 1:4145 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2616
Practice Address - Country:US
Practice Address - Phone:317-283-2780
Practice Address - Fax:317-283-4508
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01019085A207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
IND95647Medicare UPIN