Healthcare Provider Details

I. General information

NPI: 1174752802
Provider Name (Legal Business Name): LANE A NOBLE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 MERCY DR
DUBUQUE IA
52001
US

IV. Provider business mailing address

1500 ASSOCIATES DR
DUBUQUE IA
52002-2201
US

V. Phone/Fax

Practice location:
  • Phone: 563-584-3226
  • Fax: 563-584-3227
Mailing address:
  • Phone: 563-584-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO-04409
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number04409
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: