Provider Demographics
NPI:1922041714
Name:WILLIAM C. LAMBERT M.D.
Entity Type:Organization
Organization Name:WILLIAM C. LAMBERT M.D.
Other - Org Name:TYRONE FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-486-1200
Mailing Address - Street 1:110 LLOYD AVE
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-2124
Mailing Address - Country:US
Mailing Address - Phone:770-468-1200
Mailing Address - Fax:770-486-3697
Practice Address - Street 1:110 LLOYD AVE
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-2124
Practice Address - Country:US
Practice Address - Phone:770-486-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035926207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA08BDGLTMedicare PIN