Provider Demographics
NPI:1689992265
Name:LAMM, MARNIE GIBSON (MD)
Entity Type:Individual
Prefix:
First Name:MARNIE
Middle Name:GIBSON
Last Name:LAMM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7900 S. J STOCK ROAD
Mailing Address - Street 2:SAN XAVIER HEALTH CENTER, INDIAN HEALTH SERVICE
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746
Mailing Address - Country:US
Mailing Address - Phone:520-295-2481
Mailing Address - Fax:520-295-2615
Practice Address - Street 1:7900 S. J STOCK ROAD
Practice Address - Street 2:SAN XAVIER HEALTH CENTER, INDIAN HEALTH SERVICES
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746
Practice Address - Country:US
Practice Address - Phone:520-295-2481
Practice Address - Fax:520-295-2615
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ43547207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program