Max A Lungren, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2011021431 Issued in MO

Practice address

1605 Martin Springs Dr
Ste 320
Rolla, MO 65401-2931

Phone

(573) 458-6359

Fax

(573) 458-6826

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1619901048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 MARTIN SPRINGS DR",
            "address_2": "STE 320",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012931",
            "telephone_number": "573-458-6359",
            "fax_number": "573-458-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNGREN",
        "first_name": "MAX",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IA",
            "license": "28735",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2011021431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2083642",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619901048",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "43-1560263",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylee Little
• Helen Litz, NP
• Geoffrey A. Lloyd-Smith, MD
• Sarah E. Loughridge, LPC
• Michaella Luder, BSN, RN
• Kenneth Ray Lyman, FNP-BC
• William Francis Maddux, D.M.D.
• Zakary Maedgen, PA
• Christy Mahrt, AU.D.
• Mignon M Makos, MD

• Obstetrics & Gynecology Physician in Rolla, MO
• Providers in Rolla, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.