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NPI Code Detail

MEDICARE: JAMES LANE, M.D. INC

MEDICARE: JAMES LANE, M.D. INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist35044197OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
29335441OTHEROHMEDICARE GROUP PROVIDER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093909814
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMES LANE, M.D. INC
Provider Business Mailing Address
First Line : 5 SEVERANCE CIR
Second Line : #705
City : CLEVELAND HTS
State : OH
Zip : 44118-1566
Country : US
Telephone Number : 216-381-1311
Fax Number : 216-381-2606
Provider Business Practice Location Address
First Line : 5 SEVERANCE CIR
Second Line : #705
City : CLEVELAND HTS
State : OH
Zip : 44118-1566
Country : US
Telephone Number : 216-381-1311
Fax Number : 216-381-2606
Authorized Official
Title or Position : PRESIDENT
Name : JAMES LANE
Credential : M.D.
Telephone Number : 216-381-1311
Provider Enumeration Date : 09/05/2007
Last Update Date : 10/24/2007

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Directions to “JAMES LANE, M.D. INC ” Practice Location

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