1891747630 NPI number — JAMES F LOMBARDO MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891747630 NPI number — JAMES F LOMBARDO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOMBARDO
Provider First Name:
JAMES
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891747630
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 727
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIGHAM CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84302-0727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
435-734-0101
Provider Business Mailing Address Fax Number:
435-734-0103

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5475 SOUTH 500 EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OGDEN
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-479-2390
Provider Business Practice Location Address Fax Number:
801-479-2395
Provider Enumeration Date:
05/17/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , with the licence number:  2755351205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207ZP0105X , with the licence number: 2755351205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)