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Individual

JACOB W LAMB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3505 COLLEGE AVE STE B, ALTON, IL 62002
(618) 462-9695
(618) 462-9651
Mailing address
5139 MATTIS RD STE 102, SAINT LOUIS, MO 63128-2250
(314) 909-1920
(314) 909-1980

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
016005235
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
2004017476
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016005235
IL
05
301122503
MO
Enumeration date
07/18/2006
Last updated
04/10/2019
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