Provider Demographics
NPI:1386826238
Name:LAMPLEY, JAMAR SR
Entity Type:Individual
Prefix:MR
First Name:JAMAR
Middle Name:
Last Name:LAMPLEY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8216 W MARION ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1946
Mailing Address - Country:US
Mailing Address - Phone:414-788-8570
Mailing Address - Fax:414-763-1055
Practice Address - Street 1:8216 W MARION ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1946
Practice Address - Country:US
Practice Address - Phone:414-788-8570
Practice Address - Fax:414-763-1055
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41485200Medicaid