Provider Demographics
NPI:1639192974
Name:LAMBERT, WILLIAM CLARK (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLARK
Last Name:LAMBERT
Suffix:
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:PO BOX 5191
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-5191
Mailing Address - Country:US
Mailing Address - Phone:732-244-4700
Mailing Address - Fax:732-244-8482
Practice Address - Street 1:111 W WATER ST
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6407
Practice Address - Country:US
Practice Address - Phone:732-244-4700
Practice Address - Fax:732-244-8482
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03110800207ZD0900X, 207ZP0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3794806Medicaid
NJ3794806Medicaid
E54421Medicare UPIN