Provider Demographics
NPI:1659308666
Name:LAMBARD, WARREN W (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:W
Last Name:LAMBARD
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 1:108 PINE FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-9000
Mailing Address - Country:US
Mailing Address - Phone:318-377-6526
Mailing Address - Fax:
Practice Address - Street 1:108 PINE FOREST CIR
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-9000
Practice Address - Country:US
Practice Address - Phone:318-377-6526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA012648174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1187879Medicaid
LAD04140Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
LA1187879Medicaid