Provider Demographics
NPI:1477510790
Name:LAMAR, JAMES C (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:LAMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:CLAUDE
Other - Last Name:LAMAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:9280 HIGHWAY 5 STE A
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134
Mailing Address - Country:US
Mailing Address - Phone:770-949-2250
Mailing Address - Fax:770-949-1764
Practice Address - Street 1:9280 HIGHWAY 5
Practice Address - Street 2:STE A
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134
Practice Address - Country:US
Practice Address - Phone:770-949-2250
Practice Address - Fax:770-949-1764
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA032226208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00837779AMedicaid
GA00837779BMedicaid