Provider Demographics
NPI:1184735797
Name:LINDGREN, RICHARD DAN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DAN
Last Name:LINDGREN
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 1:6006 GREENTREE ROAD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-3126
Mailing Address - Country:US
Mailing Address - Phone:608-271-4494
Mailing Address - Fax:608-276-7939
Practice Address - Street 1:6006 GREENTREE ROAD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-3126
Practice Address - Country:US
Practice Address - Phone:608-271-4494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI143240202085R0202X
IA155072085R0202X
MI43010223442085R0202X
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31051100Medicaid
B54606Medicare UPIN
202753Medicare UPIN