Provider Demographics
NPI:1639148406
Name:LOMBARDI, VINCENT ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:ANTHONY
Last Name:LOMBARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5885 WILLIAM CONNER WAY
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033
Mailing Address - Country:US
Mailing Address - Phone:317-566-8346
Mailing Address - Fax:317-566-8350
Practice Address - Street 1:5885 WILLIAM CONNER WAY
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033
Practice Address - Country:US
Practice Address - Phone:317-566-8346
Practice Address - Fax:317-566-8350
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43011043192085R0202X
WAMD000458852085R0202X
NMMD2005-18312085R0202X
VA01012391152085R0202X
NV112112085R0202X
AL217052085R0202X
IN01050269A2085R0202X
TXJ83022085R0202X
PAMD-047067-L2085R0202X
AZ264642085R0202X
OH35.0872982085R0202X
FLME731382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty