MEDICARE: KEVIN M LUNSFORD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	26401	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P01440831	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	6023310	OTHER	TN	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417920273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN M LUNSFORD MD

Provider Business Mailing Address
First Line	:	1211 UNION AVE STE 330
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38104-6655
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 NEW COVINGTON PIKE
Second Line	:	SUITE 200
City	:	MEMPHIS
State	:	TN
Zip	:	38128-2591
Country	:	US
Telephone Number	:	901-516-5644
Fax Number	:	901-516-5660

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	04/16/2025

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Directions to “ KEVIN M LUNSFORD MD” Practice Location

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