Provider Demographics
NPI:1831423375
Name:WOUND HEALING GROUP, PA
Entity type:Organization
Organization Name:WOUND HEALING GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR, DIRECTOR, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:B
Authorized Official - Middle Name:LEWAYNE
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-620-8123
Mailing Address - Street 1:5221B CLIFF GOOKIN BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6781
Mailing Address - Country:US
Mailing Address - Phone:662-620-8123
Mailing Address - Fax:662-620-8131
Practice Address - Street 1:5221B CLIFF GOOKIN BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6781
Practice Address - Country:US
Practice Address - Phone:662-620-8123
Practice Address - Fax:662-620-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty