Basic Information
| Provider Information | |||||||||
| NPI: | 1558599936 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ESPELUND | ||||||||
| FirstName: | LUKE | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 PLEASANT ST | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503091406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152415926 | ||||||||
| FaxNumber: | 5152415127 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | FAIRMONT | ||||||||
| State: | MN | ||||||||
| PostalCode: | 560314575 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5072388100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2009 | ||||||||
| LastUpdateDate: | 10/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 01069781A | IN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 208000000X | MD-41872 | IA | N | Allopathic & Osteopathic Physicians | Pediatrics | 207P00000X | MD 41872 | IA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 201058720 | 05 | IN | MEDICAID |