Provider Demographics
NPI:1679652408
Name:LINDER, EDWIN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:LEE
Last Name:LINDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:30 BURTON HILLS BLVD
Mailing Address - Street 2:STE 175
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6403
Mailing Address - Country:US
Mailing Address - Phone:615-988-2014
Mailing Address - Fax:615-208-1303
Practice Address - Street 1:107 EUREKA ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-2533
Practice Address - Country:US
Practice Address - Phone:662-563-7681
Practice Address - Fax:662-563-2611
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2017-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS14424207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0113816Medicaid
MSF85326Medicare UPIN
MS080002595Medicare ID - Type Unspecified