Provider Demographics
NPI:1831192277
Name:LAMB, SCOTT JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JOSEPH
Last Name:LAMB
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 1:901 TURTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1947
Mailing Address - Country:US
Mailing Address - Phone:903-596-3588
Mailing Address - Fax:903-594-2038
Practice Address - Street 1:700 OLYMPIC PLAZA CIR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1951
Practice Address - Country:US
Practice Address - Phone:903-596-3504
Practice Address - Fax:903-596-3604
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK08852081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH084321OtherSTATE MEDICAL BOARD
TX30505403Medicaid
TX8G9346OtherMEDICARE ID
TX8X1170OtherBLUE CROSS BLUE SHIELD
TX30505403Medicaid