MEDICARE: MICHAEL F. LOMBARD MD STANLEY A. LOBITZ MD GEN PTRS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD029325E	PA

General Provider Information

NPI Number	:	1508924069
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL F. LOMBARD MD STANLEY A. LOBITZ MD GEN PTRS

Provider Business Mailing Address
First Line	:	155 E BENNETT ST
Second Line	:
City	:	KINGSTON
State	:	PA
Zip	:	18704-4940
Country	:	US
Telephone Number	:	570-283-5611
Fax Number	:	570-283-5613

Provider Business Practice Location Address
First Line	:	155 E BENNETT ST
Second Line	:
City	:	KINGSTON
State	:	PA
Zip	:	18704-4940
Country	:	US
Telephone Number	:	570-283-5611
Fax Number	:	570-283-5613

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. LISA C LOMBARD
Credential	:	RN
Telephone Number	:	570-283-5611

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	04/01/2008

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