Provider Demographics
NPI:1124072657
Name:LOMBARDI, ANN M (MD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-367-3360
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:1850 BLUEGRASS AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1161
Practice Address - Country:US
Practice Address - Phone:502-367-3360
Practice Address - Fax:502-367-3365
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY33680207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000722071OtherANTHEM-CMA AUD.WEST
KY000057120BOtherHUMANA-CMA AUD.WEST
KY6322876OtherCIGNA-CMA AUD.WEST
KY50033198OtherPASSPORT- CMA AUD. WEST
IN200437790OtherIN MEDICAID- CMA -AUDUBON WEST
KY64336803Medicaid
KYK002080OtherMEDICARE PTAN/ CMA AUD.WEST
KY125854OtherSIHO-CMA AUD.WEST
KY125854OtherSIHO-CMA AUD.WEST
KY000000722071OtherANTHEM-CMA AUD.WEST
IN200437790OtherIN MEDICAID- CMA -AUDUBON WEST