Provider Demographics
NPI:1215155890
Name:PARADISE, LINDY KURZ (MD)
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:KURZ
Last Name:PARADISE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 HIGHLAND BLVD
Mailing Address - Street 2:STE 1180
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6905
Mailing Address - Country:US
Mailing Address - Phone:406-587-8631
Mailing Address - Fax:406-587-8631
Practice Address - Street 1:925 HIGHLAND BLVD
Practice Address - Street 2:STE 1180
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6905
Practice Address - Country:US
Practice Address - Phone:406-587-8631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-21
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA371482085R0202X
TXL94162085R0202X
MT117062085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA04598OtherWELLMARK BCBS
IA04598OtherWELLMARK BCBS
IAP00405455Medicare PIN