Provider Demographics
NPI:1740394154
Name:LAMB, JACQUELYN MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:JACQUELYN
Middle Name:MARIE
Last Name:LAMB
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:23 WHITES PATH STE F
Mailing Address - Street 2:YARMOUTH MEDICAL CENTER
Mailing Address - City:SOUTH YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02664-1238
Mailing Address - Country:US
Mailing Address - Phone:508-760-2054
Mailing Address - Fax:508-760-1218
Practice Address - Street 1:23 WHITES PATH STE F
Practice Address - Street 2:YARMOUTH MEDICAL CENTER
Practice Address - City:SOUTH YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02664-1238
Practice Address - Country:US
Practice Address - Phone:508-760-2054
Practice Address - Fax:508-760-1218
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2009-12-18
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Provider Licenses
StateLicense IDTaxonomies
MA59740207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1409032OtherAETNA
J07461 - SS0041OtherBCBSMA
2369673OtherCIGNA
MA3035450Medicaid
726827OtherTUFTS HEALTH CARE
0005762OtherNHP
726827OtherTUFTS MEDICARE PREFERRED
J07461OtherMEDICARE
042297845OtherMULTI-PLAN
042297845OtherUNITED HEALTH CARE
AA72328OtherHARVARD PILGRIM
042297845OtherHCVM/FIRST HEALTH/COVENTY
042297845OtherTRICARE
042297845OtherGIC/UNICARE
042297845OtherGREAT WEST HEALTH CARE
29557OtherFALLON