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Individual

MR. DESTRY W LAMBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
403 FAIRGROUNDS RD, TIPTON, IN 46072-9596
(765) 675-7601
(765) 675-8052
Mailing address
PO BOX 358, TIPTON, IN 46072-0358
(765) 675-8119
(765) 675-8257

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01024399
IN
208D00000X
General Practice Physician
01024399A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100233710A
IN
Enumeration date
10/18/2005
Last updated
09/24/2008
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