Healthcare Provider Details

I. General information

NPI: 1427146588
Provider Name (Legal Business Name): CYNTHIA J LUND D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 E PIKES PEAK AVE SUITE 200
COLORADO SPRINGS CO
80909-6022
US

IV. Provider business mailing address

2 S CASCADE AVE STE 140
COLORADO SPRINGS CO
80903-1604
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-6840
  • Fax: 719-365-6774
Mailing address:
  • Phone: 719-538-2900
  • Fax: 719-538-2987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25583
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: