Provider Demographics
NPI:1689781007
Name:LAMPTON, LUCIUS M (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCIUS
Middle Name:M
Last Name:LAMPTON
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 1:111 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:MS
Mailing Address - Zip Code:39652-2825
Mailing Address - Country:US
Mailing Address - Phone:601-783-2374
Mailing Address - Fax:601-783-5126
Practice Address - Street 1:111 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:MS
Practice Address - Zip Code:39652-2825
Practice Address - Country:US
Practice Address - Phone:601-783-2374
Practice Address - Fax:601-783-5126
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14108207Q00000X
LAMD.200967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0112122Medicaid
MSF62567Medicare UPIN