Provider Demographics
NPI:1255360731
Name:LAMBIRD, ELIZABETH ANN I (DO)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:LAMBIRD
Suffix:I
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1200 E WOODHURST DR STE K200
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-3773
Mailing Address - Country:US
Mailing Address - Phone:417-886-0362
Mailing Address - Fax:417-886-0363
Practice Address - Street 1:1200 E WOODHURST DR STE K200
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-3773
Practice Address - Country:US
Practice Address - Phone:417-886-0362
Practice Address - Fax:417-886-0363
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002002064207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO245859103Medicaid
MO31484016OtherBCBS
MOM60B891Medicare PIN