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General NPI Number Information
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NPI Number | 1578539482
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Entity Type | Individual
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Provider Name | JOEL ROBIN LANE MD
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Gender | Male
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | BANNER PHYSICIAN SPECIALISTS 37100 N. GANTZEL RD. STE. 107
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City | QUEEN CREEK
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State | AZ
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Zip | 84140
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Country | US
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Telephone | 480-394-4480
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Fax | 602-805-2823
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Provider Business Mailing Address
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Address Line | 7450 KESSLER ST STE 140
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City | SHAWNEE MISSION
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State | KS
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Zip | 66204-2519
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Country | US
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Telephone | 913-362-8317
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Fax | 913-362-0169
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 04-28701
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License Number State | KS
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