Provider Demographics
NPI:1508924069
Name:MICHAEL F. LOMBARD MD STANLEY A. LOBITZ MD GEN PTRS
Entity Type:Organization
Organization Name:MICHAEL F. LOMBARD MD STANLEY A. LOBITZ MD GEN PTRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOMBARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:570-283-5611
Mailing Address - Street 1:155 E BENNETT ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-4940
Mailing Address - Country:US
Mailing Address - Phone:570-283-5611
Mailing Address - Fax:570-283-5613
Practice Address - Street 1:155 E BENNETT ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-4940
Practice Address - Country:US
Practice Address - Phone:570-283-5611
Practice Address - Fax:570-283-5613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029325E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA131529Medicare PIN