Individual
JOHN RUSSELL LINDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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