Healthcare Provider Details

I. General information

NPI: 1982969846
Provider Name (Legal Business Name): PAUL JOSEPH LANIER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2012
Last Update Date: 10/28/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W UTOPIA RD STE 100
PHOENIX AZ
85027-4172
US

IV. Provider business mailing address

2500 W UTOPIA RD STE 100
PHOENIX AZ
85027-4172
US

V. Phone/Fax

Practice location:
  • Phone: 801-471-7340
  • Fax:
Mailing address:
  • Phone: 801-471-7340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number20A18085
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number008200
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: