Provider Demographics
NPI:1497976260
Name:STUART A NAULTY & ROGER D LAMPKIN
Entity Type:Organization
Organization Name:STUART A NAULTY & ROGER D LAMPKIN
Other - Org Name:DRS. NAULTY & LAMPKIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAULTY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:270-753-0666
Mailing Address - Street 1:908 S 12TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2949
Mailing Address - Country:US
Mailing Address - Phone:270-753-0666
Mailing Address - Fax:270-753-0684
Practice Address - Street 1:908 S 12TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2949
Practice Address - Country:US
Practice Address - Phone:270-753-0666
Practice Address - Fax:270-753-0684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00160332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY90005646Medicaid
KY90005646Medicaid