Basic Information
| Provider Information | |||||||||
| NPI: | 1689651390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAMBERT | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1835 SAVOY DR | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303411072 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707609949 | ||||||||
| FaxNumber: | 7707609951 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 MILSTEAD RD NE STE 110 | ||||||||
| Address2: | |||||||||
| City: | CONYERS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300123849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7707609949 | ||||||||
| FaxNumber: | 7707609951 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/23/2005 | ||||||||
| LastUpdateDate: | 12/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 070216 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 003129889E | 05 | GA | MEDICAID | 003136604F | 05 | GA | MEDICAID | 003136604E | 05 | GA | MEDICAID | 003136604A | 05 | GA | MEDICAID |