Healthcare Provider Details

I. General information

NPI: 1750378097
Provider Name (Legal Business Name): JAMES F LANIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 08/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19643 TENADA AVE
CHUGIAK AK
99567
US

IV. Provider business mailing address

19643 TENADA AVE
CHUGIAK AK
99567
US

V. Phone/Fax

Practice location:
  • Phone: 907-562-2211
  • Fax: 907-565-8066
Mailing address:
  • Phone: 907-565-8055
  • Fax: 907-565-8066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number1094
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: