Provider Demographics
NPI:1427511641
Name:KREBS, LINDY WILLIAMS (MD)
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:WILLIAMS
Last Name:KREBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDY
Other - Middle Name:ANN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1600 SW ARCHER RD STE N1-07
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-3003
Mailing Address - Country:US
Mailing Address - Phone:352-273-5143
Mailing Address - Fax:
Practice Address - Street 1:410 NE WALDO RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32641-5685
Practice Address - Country:US
Practice Address - Phone:352-265-7015
Practice Address - Fax:352-265-7021
Is Sole Proprietor?:No
Enumeration Date:2019-04-14
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME155001207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114467200Medicaid