Provider Demographics
NPI:1205179157
Name:WEBB, LARS ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:LARS
Middle Name:ROBERT
Last Name:WEBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1934 ALCOA HWY STE 285
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1528
Mailing Address - Country:US
Mailing Address - Phone:865-305-9620
Mailing Address - Fax:865-525-3460
Practice Address - Street 1:1934 ALCOA HWY STE 285
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920
Practice Address - Country:US
Practice Address - Phone:865-305-9620
Practice Address - Fax:865-525-3460
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
TN57463208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program