Provider Demographics
NPI:1821020892
Name:LAMPONE, THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:LAMPONE
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:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32562-0355
Mailing Address - Country:US
Mailing Address - Phone:850-406-2282
Mailing Address - Fax:877-879-2339
Practice Address - Street 1:104 MATAMOROS DR
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-5234
Practice Address - Country:US
Practice Address - Phone:850-406-2282
Practice Address - Fax:877-879-2339
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0052223207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00080293OtherRAILROAD MEDICARE
AL590-70714OtherBLUE CROSS BLUE SHIELD
FL07371OtherBLUE CROSS BLUE SHIELD
FL262644600Medicaid
B69584Medicare UPIN
FL07371Medicare PIN