Basic Information
| Provider Information | |||||||||
| NPI: | 1326018839 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANEY | ||||||||
| FirstName: | PHILLIP | ||||||||
| MiddleName: | LEONARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 930 FRANKLIN ST SE | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358014312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565394080 | ||||||||
| FaxNumber: | 2565394099 | ||||||||
| Practice Location | |||||||||
| Address1: | 930 FRANKLIN ST SE | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358014312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565394080 | ||||||||
| FaxNumber: | 2565394099 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2006 | ||||||||
| LastUpdateDate: | 12/11/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 13405 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 112223 | 05 | AL | MEDICAID | 112225 | 05 | AL | MEDICAID | 112229 | 05 | AL | MEDICAID | 51033798 | 01 | AL | BCBS | OTHER | 112219 | 05 | AL | MEDICAID | 4279644 | 01 | AETNA | OTHER | 515-98652 | 01 | AL | BCBS | OTHER | P00765573 | 01 | AL | RAILROAD MEDICARE | OTHER | 000033798 | 05 | AL | MEDICAID | 0173786 | 01 | TN | BCBS | OTHER | 112233 | 05 | AL | MEDICAID | 510-49266 | 01 | AL | BCBS | OTHER | 515-98654 | 01 | AL | BCBS | OTHER | 510-49264 | 01 | AL | BCBS | OTHER | 060037258 | 01 | RAILROAD MEDICARE | OTHER | 112239 | 05 | AL | MEDICAID | 25-10262 | 01 | UNITED HEALTHCARE | OTHER | 510-49265 | 01 | AL | BCBS | OTHER | 515-98653 | 01 | AL | BCBS | OTHER |