Provider Demographics
NPI:1790073336
Name:LAMPERT, JARRED S (PA)
Entity Type:Individual
Prefix:MR
First Name:JARRED
Middle Name:S
Last Name:LAMPERT
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:PO BOX 1028
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-1028
Mailing Address - Country:US
Mailing Address - Phone:812-996-0410
Mailing Address - Fax:812-996-8497
Practice Address - Street 1:695 W 2ND ST
Practice Address - Street 2:SUITE A2
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3240
Practice Address - Country:US
Practice Address - Phone:812-996-6500
Practice Address - Fax:812-996-6502
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2014-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN1001300A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant