Provider Demographics
NPI:1568813558
Name:LAMBERT, JOHN CORDEAUX (NP)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CORDEAUX
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1036 D A BIGLANE DR
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-2331
Mailing Address - Country:US
Mailing Address - Phone:601-835-1182
Mailing Address - Fax:601-835-1546
Practice Address - Street 1:1036 D A BIGLANE DR
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-2331
Practice Address - Country:US
Practice Address - Phone:601-835-1182
Practice Address - Fax:601-835-1546
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS901614363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner