Longobardo, Vincent B

Longobardo, Vincent B is an sole proprietor health care provider with primary practice located at 19 Miracle Ln Suite 200, Crossville TN 38555-7654. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, which is considered as his primary health care specialty. Longobardo, Vincent B can be contacted via phone (931) 707-8352.

Contact Information

Primary practice address
19 Miracle Ln Suite 200 Crossville TN 38555-7654
Phone: (931) 707-8352
Fax: (931) 707-8053
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X DPM0000000520 Tennessee

Profile Details

NPI number 1043207988
LBN Legal business name Longobardo, Vincent B
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2005
Last updated Sep 27th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043207988 NPPES
Tennessee MEDICAID 3352893

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