Basic Information
| Provider Information | |||||||||
| NPI: | 1972604916 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LINDBERG | ||||||||
| FirstName: | ERIC | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 E. HALE PKWY | ||||||||
| Address2: | STE 550 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802204053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033216600 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4700 E. HALE PKWY | ||||||||
| Address2: | STE 550 | ||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802204053 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033216600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2006 | ||||||||
| LastUpdateDate: | 06/24/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0004X | 36983 | CO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery |
ID Information
| ID | Type | State | Issuer | Description | 01369834 | 05 | CO | MEDICAID |