Provider Demographics
NPI:1598954968
Name:MARK A LAMBERT
Entity Type:Organization
Organization Name:MARK A LAMBERT
Other - Org Name:PENSACOLA FOOT AND ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:850-477-9015
Mailing Address - Street 1:4850 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2407
Mailing Address - Country:US
Mailing Address - Phone:850-477-9015
Mailing Address - Fax:850-478-5227
Practice Address - Street 1:4850 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2407
Practice Address - Country:US
Practice Address - Phone:850-477-9015
Practice Address - Fax:850-478-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2803213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL38932OtherBCBS OF FLORIDA
FL1285300001Medicare NSC
FLK1034Medicare PIN
FL38932OtherBCBS OF FLORIDA