Basic Information
| Provider Information | |||||||||
| NPI: | 1912065640 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOMBARD | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 E BENNETT ST | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702835611 | ||||||||
| FaxNumber: | 5702835613 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 E BENNETT ST | ||||||||
| Address2: | |||||||||
| City: | KINGSTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 18704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702835611 | ||||||||
| FaxNumber: | 5702835613 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2006 | ||||||||
| LastUpdateDate: | 03/03/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD029325E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.