Paul E Lundstrom, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

8740 Issued in AZ

Practice address

77 W Forest Ave
Suite 201
Flagstaff, AZ 86001-1479

Phone

(928) 773-2222

Fax

(928) 773-2598

NPI assigned

Mar 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1487623476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10577",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852710577",
            "telephone_number": "928-773-2222",
            "fax_number": "928-773-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE",
            "address_2": "SUITE 201",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011479",
            "telephone_number": "928-773-2222",
            "fax_number": "928-773-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDSTROM",
        "first_name": "PAUL",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "8740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD AZ",
            "identifier": "AZ0801620",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202226",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Todd Ludwig, M.D.
• Abigail Lund
• Alexander Davis Lund, D.O.
• Charidee Ann Lund, RN
• Erica Lundeen
• Alaina Luneau, LCSW
• Mackenzie R Lurie, PA
• Della S Lusk, PH.D.
• Lee W Lusk
• Lesley Diana Lutes, PHD

• Surgery Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.