Provider Demographics
NPI:1396037446
Name:LAMP, KIMBERLY M (DO)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:LAMP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-2050
Mailing Address - Fax:717-812-2052
Practice Address - Street 1:4222 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17406-8083
Practice Address - Country:US
Practice Address - Phone:717-812-2050
Practice Address - Fax:717-812-2052
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA358141EZ3Medicare PIN
PAP01526242Medicare PIN
PA358141FLTMedicare PIN