Healthcare Provider Details

I. General information

NPI: 1316556525
Provider Name (Legal Business Name): LINDSEY JUNG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2020
Last Update Date: 12/02/2021
Certification Date: 12/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HIGHLAND AVENUE
MADISON WI
53792
US

IV. Provider business mailing address

600 HIGHLAND AVENUE
MADISON WI
53792
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-6400
  • Fax:
Mailing address:
  • Phone: 608-263-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPH60955632
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: