Provider Demographics
NPI:1710097563
Name:LAMPARD, SIMON D (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:D
Last Name:LAMPARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1701 12TH AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-3100
Mailing Address - Country:US
Mailing Address - Phone:814-943-7040
Mailing Address - Fax:814-943-7002
Practice Address - Street 1:1701 12TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-3100
Practice Address - Country:US
Practice Address - Phone:814-943-7040
Practice Address - Fax:814-943-7002
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD071315L2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF90056Medicare UPIN