MEDICARE: DR. TODD JAMES LUMSDEN D.O.

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	207W00000X	Ophthalmology Physician	112497	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	180029379	OTHER	MO	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2324214	OTHER	MO	UNITED HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	59946	OTHER	MO	HEALTH ALLIANCE
5	106713	OTHER	MO	BLUE SHIELD
6	27949	OTHER	MO	GHP
7	332866	OTHER	MO	HEALTHLINK

General Provider Information

NPI Number	:	1689670887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD JAMES LUMSDEN D.O.

Provider Business Mailing Address
First Line	:	360 S MOUNT AUBURN RD
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-4920
Country	:	US
Telephone Number	:	573-335-3577
Fax Number	:	573-335-1559

Provider Business Practice Location Address
First Line	:	64 DOCTORS PARK
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63703-4928
Country	:	US
Telephone Number	:	573-334-5265
Fax Number	:	573-334-3648

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/27/2020

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