Basic Information
| Provider Information | |||||||||
| NPI: | 1568917037 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHRIS A LANE DO INC PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4505 BLACKBERRY RUN | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731126157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054706767 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4505 BLACKBERRY RUN | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731126157 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053437602 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2016 | ||||||||
| LastUpdateDate: | 12/27/2018 | ||||||||
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| AuthorizedOfficialLastName: | LANE | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
| AuthorizedOfficialMiddleName: | ALAN | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4053437602 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 3863 | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.