Provider Demographics
NPI:1457606584
Name:STURM, LINDSAY JO (DO)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:JO
Last Name:STURM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:JO
Other - Last Name:PECKSKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2122 LEOPOLD DR
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4499
Mailing Address - Country:US
Mailing Address - Phone:320-333-3190
Mailing Address - Fax:
Practice Address - Street 1:2122 LEOPOLD DR
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-4499
Practice Address - Country:US
Practice Address - Phone:320-333-3190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012021514207Y00000X
TN3343208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNFP4017162OtherDEA