| Doctor Name: | VINCENT B LONGOBARDO |
| NPI Number: | 1043207988 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | DPM0000000520 |
| Business Practice Address: | 19 Miracle Ln Suite 200 Crossville, TN - 385557654 |
| Business Phone Number: | 9317078352 |
| Business Fax Number: | 9317078053 |
| Mailing Address: | Po Box 8, CROSSVILLE |
| State: | TN |
| Postal Code: | 385570008 |
| Phone Number: | 9317078352 |
| Fax Number: | 9317078053 |
| NPI Enumeration Date: | 10/05/2005 |
| NPI Last Update Date: | 09/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | DPM0000000520 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |