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Individual

ROBERT P. LONERGAN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1244 PRIMACY PKWY, MEMPHIS, TN 38119
(901) 767-8662
(901) 767-8666
Mailing address
6077 PRIMACY PKWY STE 140, MEMPHIS, TN 38119-5742
(901) 725-8347
(901) 259-7637

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
38131
TN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
38131
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00001072832 15
UNITED HEALTHCARE
TN
05
07187860
MS
05
3371161
TN
05
3889622
TN
01
4179729
BCBS
TN
01
5976219
CIGNA
TN
01
620819926
CIGNA
TN
01
7239223
AETNA
TN
05
9025301
MS
01
P00618041
RAILROAD MEDICARE
TN
Enumeration date
02/23/2006
Last updated
06/19/2019
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