| Organization Name: | DESTRY W LAMBERT MD INC |
| NPI Number: | 1033392808 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINNIE JEAN ROGERS (OFC MGN) |
| Mailing Address: | 403 Fairgrounds Rd Tipton |
| State: | IN US |
| Postal Code: | 460729596 |
| Phone Number: | 7656757601 |
| Fax Number: | 7656758052 |
| NPI Enumeration Date: | 12/14/2007 |
| NPI Last Update Date: | 12/14/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 01024399 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |