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General NPI Number Information
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NPI Number | 1376750414
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Entity Type | Organization
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Legal Business Name | LANE EYE CARE CENTER, P.A.
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 10700 N RODNEY PARHAM RD
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City | LITTLE ROCK
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State | AR
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Zip | 72212-4113
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Country | US
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Telephone | 501-225-4648
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Fax | 501-225-8628
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Provider Business Mailing Address
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Address Line | 10700 N RODNEY PARHAM RD
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City | LITTLE ROCK
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State | AR
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Zip | 72212-4113
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Country | US
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Telephone | 501-225-4648
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Fax | 501-225-8628
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MILTON J LANE
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Credential | O.D.
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Telephone | 501-225-4648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2219
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License Number State | AR
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