Provider Demographics
NPI:1184635732
Name:LINDEMANN, JON P (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:P
Last Name:LINDEMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-614-2006
Mailing Address - Fax:501-526-6562
Practice Address - Street 1:4301 W MARKHAM ST # 783
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-614-2006
Practice Address - Fax:501-526-6562
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4042207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR89-W647OtherMALP INS
AR116114001Medicaid
AR89-W647OtherMALP INS
AR5AB39Medicare PIN
ARE10473Medicare UPIN