Provider Demographics
NPI:1902945058
Name:LAMBRECHT, JON K (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:K
Last Name:LAMBRECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:407 EAST AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5290
Practice Address - Country:US
Practice Address - Phone:401-726-7770
Practice Address - Fax:401-726-7775
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD06639207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1902945058Medicaid
RI7003350Medicaid
MA1902945058Medicaid
RI7003350Medicaid