Provider Demographics
NPI:1467549865
Name:LAMBERT, JENNIFER L (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1100 N KENTUCKY AVE
Mailing Address - Street 2:P.O. BOX 1100
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2029
Mailing Address - Country:US
Mailing Address - Phone:417-256-9111
Mailing Address - Fax:417-257-5947
Practice Address - Street 1:500 E 19TH ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN GROVE
Practice Address - State:MO
Practice Address - Zip Code:65711-1114
Practice Address - Country:US
Practice Address - Phone:417-926-6563
Practice Address - Fax:417-926-5820
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2016-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOT011902207Q00000X
MO2010024114207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00852014OtherRAILROAD MEDICARE GROUP CB9013
MO1467549865Medicaid
431560263OtherTRICARE WEST
431560263OtherTRICARE WEST
P00852014OtherRAILROAD MEDICARE GROUP CB9013