Provider Demographics
NPI:1396085015
Name:LUND, MARION SHAUN (DPM)
Entity type:Individual
Prefix:DR
First Name:MARION
Middle Name:SHAUN
Last Name:LUND
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:M
Other - Middle Name:SHAUN
Other - Last Name:LUND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:1735 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-4109
Mailing Address - Country:US
Mailing Address - Phone:662-234-3668
Mailing Address - Fax:662-281-0002
Practice Address - Street 1:1735 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-4109
Practice Address - Country:US
Practice Address - Phone:662-234-3668
Practice Address - Fax:662-281-0002
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS80222213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04585320Medicaid