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General NPI Number Information
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NPI Number | 1518961960
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Entity Type | Individual
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Provider Name | LANE ROLAND M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 4004 DUPONT CIR STE 230
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City | LOUISVILLE
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State | KY
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Zip | 40207-4819
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Country | US
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Telephone | 502-893-1333
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Fax | 502-899-9576
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Provider Business Mailing Address
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Address Line | 5200 COMMERCE CROSSINGS DR FL 3
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City | LOUISVILLE
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State | KY
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Zip | 40229-2182
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Country | US
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Telephone | 502-489-6613
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Fax | 502-489-5751
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35849
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License Number State | KY
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