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JOHN RUSSELL LINDSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2116 CRAIG RD, EAU CLAIRE, WI 54701-6149
(715) 858-4650
(715) 858-4511
Mailing address
2116 CRAIG RD, EAU CLAIRE, WI 54701-6149
(715) 858-4650
(715) 858-4511

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
22441
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
064237001
MEDICARE DME
05
30283000
WI
01
41708100
MEDICAID DME
WI
Enumeration date
05/23/2006
Last updated
06/06/2011
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