Provider Demographics
NPI:1770521577
Name:LUNDERS, WILLIAM GEORGE (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GEORGE
Last Name:LUNDERS
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:PO BOX 634706
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:391 WALLACE RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4851
Practice Address - Country:US
Practice Address - Phone:615-781-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40397207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4124226OtherBLUE CROSS
TN4119212OtherBLUE CROSS
TN3337703Medicaid
TN3337704Medicaid
TN3337245Medicaid
TNP00318700OtherMEDICARE RAILROAD
TN4119213OtherBLUE CROSS
TN41238OtherTLC TENNCARE
TN41238OtherTLC TENNCARE
TN3337703Medicare PIN
TN3337245Medicaid
TN3337245Medicare PIN