MEDICARE: JEFFREY J LUNN 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	25691	MN
2	207L00000X	Anesthesiology Physician	20495	AZ
3	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	20495	AZ
4	207L00000X	Anesthesiology Physician	2000234	NM

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

General Provider Information

NPI Number	:	1578527347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY J LUNN MD

Provider Business Mailing Address
First Line	:	3269 STOCKTON HILL RD
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86409-3619
Country	:	US
Telephone Number	:	928-897-9799
Fax Number	:

Provider Business Practice Location Address
First Line	:	3269 STOCKTON HILL RD
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86409-3619
Country	:	US
Telephone Number	:	928-757-2101
Fax Number	:

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

Provider Enumeration Date	:	04/17/2006
Last Update Date	:	09/20/2023

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