Provider Demographics
NPI:1073837332
Name:LOMBARD, EMILY ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ELIZABETH
Last Name:LOMBARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2311 N PROSPECT AVE STE 4C
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-4445
Mailing Address - Country:US
Mailing Address - Phone:414-319-3204
Mailing Address - Fax:414-319-3095
Practice Address - Street 1:2311 N PROSPECT AVE STE 4C
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4445
Practice Address - Country:US
Practice Address - Phone:414-319-3204
Practice Address - Fax:414-319-3095
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.122486207V00000X
WI72225207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology