Provider Demographics
NPI:1649772724
Name:RANDOLPH L. LAMBERSON MD PC
Entity Type:Organization
Organization Name:RANDOLPH L. LAMBERSON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAMBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-369-7262
Mailing Address - Street 1:1230 HIGHLAND LAKES TRL
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6850
Mailing Address - Country:US
Mailing Address - Phone:205-369-7262
Mailing Address - Fax:
Practice Address - Street 1:198 NARROWS DR STE 103
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-8663
Practice Address - Country:US
Practice Address - Phone:205-848-8420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-05
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00015951207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty