Healthcare Provider Details

I. General information

NPI: 1780892505
Provider Name (Legal Business Name): ROBERT MICHAEL LANE AART
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BOBBY M LANE SR. AART

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 SW 6TH ST
TOPEKA KS
66604
US

IV. Provider business mailing address

3642 W 10TH ST
LAWRENCE KS
66049-3227
US

V. Phone/Fax

Practice location:
  • Phone: 785-783-8875
  • Fax:
Mailing address:
  • Phone: 785-856-1226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number2202833
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: