Individual
LONNIE JOSEPH BARGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 TRILLIUM WAY, CORBIN, KY 40701-8727
(606) 523-8542
(606) 523-8708
Mailing address
PO BOX 1325, CORBIN, KY 40702-1325
(606) 526-8131
(606) 528-8661
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
43375
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100056420
—
KY
01
—
P01462910
RR MEDICARE
KY
Enumeration date
07/16/2008
Last updated
12/09/2020
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