Healthcare Provider Details

I. General information

NPI: 1356573117
Provider Name (Legal Business Name): LINDSAY POWELL LOMBARDO D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY MARIE LOMBARDO DO

II. Dates (important events)

Enumeration Date: 08/12/2009
Last Update Date: 02/17/2021
Certification Date: 02/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 SOUTH SPRING AVE SLUCARE ACADEMIC PAVILLION, 1ST FLOOR
SAINT LOUIS MO
63110-3714
US

IV. Provider business mailing address

1008 SOUTH SPRING AVE SLUCARE ACADEMIC PAVILLION, 1ST FLOOR
SAINT LOUIS MO
63110-3714
US

V. Phone/Fax

Practice location:
  • Phone: 314-977-3470
  • Fax: 314-977-1642
Mailing address:
  • Phone: 314-977-3470
  • Fax: 314-977-1642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number2015023520
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: