Provider Demographics
NPI:1073833364
Name:SPEER, LYDIA B (DO)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:B
Last Name:SPEER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:975 E 3RD ST
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2147
Mailing Address - Country:US
Mailing Address - Phone:423-778-5630
Mailing Address - Fax:423-778-3146
Practice Address - Street 1:1751 GUNBARREL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7177
Practice Address - Country:US
Practice Address - Phone:423-778-8909
Practice Address - Fax:423-778-8910
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116022586207Q00000X
TN2820207Q00000X
SC36172207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine