Provider Demographics
NPI:1679774178
Name:LINDBERG, REBECCA LYNN (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:LINDBERG
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 1:1275 DICK LONAS RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1383
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-381-1509
Practice Address - Street 1:400 Y ST
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-6243
Practice Address - Country:US
Practice Address - Phone:423-639-0707
Practice Address - Fax:833-908-2071
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN70896207R00000X
IN01068594A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200996230Medicaid
IN000000675964OtherANTHEM
INM400065038Medicare PIN
INM400024387Medicare PIN
INP01210339Medicare PIN