Provider Demographics
NPI:1609086057
Name:LAMB, STEPHEN BURNHAM II (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:BURNHAM
Last Name:LAMB
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40507-1040
Mailing Address - Country:US
Mailing Address - Phone:859-253-9024
Mailing Address - Fax:859-253-0095
Practice Address - Street 1:436 W 2ND ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-1040
Practice Address - Country:US
Practice Address - Phone:859-253-9024
Practice Address - Fax:859-253-0095
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY214662084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64214661Medicaid
KY1598201Medicare ID - Type Unspecified
KY64214661Medicaid