Provider Demographics
NPI:1407930613
Name:LEGINO, LONNY JOE (MD)
Entity Type:Individual
Prefix:MR
First Name:LONNY
Middle Name:JOE
Last Name:LEGINO
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 1:7205 W CENTER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2380
Mailing Address - Country:US
Mailing Address - Phone:402-397-6600
Mailing Address - Fax:402-397-8318
Practice Address - Street 1:7205 W CENTER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2388
Practice Address - Country:US
Practice Address - Phone:402-397-6600
Practice Address - Fax:402-397-8318
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16683207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470726068Medicaid
IA0910067Medicaid
IA0910067Medicaid
NE087641Medicare ID - Type Unspecified
NE160005812Medicare ID - Type UnspecifiedRAILROAD MEDICARE