Provider Demographics
NPI:1700024577
Name:LAMPERT, BRENT CHARLES (DO)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:CHARLES
Last Name:LAMPERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-2594
Mailing Address - Fax:
Practice Address - Street 1:920 N HAMILTON RD
Practice Address - Street 2:SUITE 400
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1757
Practice Address - Country:US
Practice Address - Phone:614-293-7677
Practice Address - Fax:614-293-5614
Is Sole Proprietor?:No
Enumeration Date:2009-02-01
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015422207R00000X
OH010994207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0088483Medicaid
OHH234130Medicare PIN