Basic Information
| Provider Information | |||||||||
| NPI: | 1730177965 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LANHAM | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | SETON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 HOSPITAL ROAD | ||||||||
| Address2: | |||||||||
| City: | FORT GORDON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309055650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067879355 | ||||||||
| FaxNumber: | 7067879356 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 HOSPITAL DRIVE | ||||||||
| Address2: | FAMILY MEDICINE CLINIC | ||||||||
| City: | FORT GORDON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309055650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067879355 | ||||||||
| FaxNumber: | 7067879356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2005 | ||||||||
| LastUpdateDate: | 10/08/2013 | ||||||||
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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 | 207Q00000X | D0060943 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.