Provider Demographics
NPI:1760473383
Name:LAMPE, RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:LAMPE
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 1:2211 LOMAS BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-2719
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2719
Practice Address - Country:US
Practice Address - Phone:806-787-0224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2653208000000X, 2080P0208X
NMMD2022-1390208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100065540AMedicaid
TX137934908Medicaid
TX52493OtherPRESBYTERIAN COMMERCIAL
NMA103OtherTRIWEST
TX117315104Medicaid
NM52493Medicaid
TX86K886OtherBC/BS
NMH1713Medicaid
TX117315101OtherFIRSTCARE COMMERCIAL
TX137934905Medicaid
TX80823ZOtherHMO BLUE
TX137934908Medicaid
NMA103OtherTRIWEST
TX137934905Medicaid