Jeremy Brandon Lamb, PHYSICIAN ASSISTANT
Individual provider Active NPI Physician Assistant · Newcastle, OK
NPI 1780915413 · NPPES record last updated Apr 8, 2014
Key facts
- NPI
- 1780915413
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1870 (OK)
- Practice address
- 2318 SE 44TH St
Newcastle, OK 73065-4702 - Phone
- (450) 387-9323
- NPI assigned
- Jan 20, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130613000412 | OK | Practitioner - Physician Assistant | 0042459570 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1870 | OK | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1870 | OK | Yes |
Addresses
Primary practice location
2318 SE 44TH St
Newcastle, OK 73065-4702
Mailing address
1409 Jaxon CT
Yukon, OK 73099-7713
Phone (405) 473-2035
Other providers in Newcastle, OK
- Kameron Kimberly Ann Homier
- Cortney Suzanne Hoyt
- Jeramiah Walker Aprn CNP PLLC
- Jim E Cox DDS PC
- Michael Koprivnik
- Amanda Larae Lawrence
- Amy Le
- Barbara Payton Lewis
- Catina Wane Lewis
- Emily G Littlejohn
All providers in Newcastle, OK · Physician Assistant in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.