Healthcare Provider Details

I. General information

NPI: 1831355148
Provider Name (Legal Business Name): JOHN ALLEN LANNING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SYCAMORE
ANNA MARIA FL
34216
US

IV. Provider business mailing address

PO BOX 1413
ANNA MARIA FL
34216-1413
US

V. Phone/Fax

Practice location:
  • Phone: 941-778-3318
  • Fax:
Mailing address:
  • Phone: 941-778-3318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME70196
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: