Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 35-058066 | OH |
NPI | 1013023829 |
---|---|
Provider Name | Dr. James Scott Lane |
First Address | Cleveland, OH 44114-1158 |
Second Address | Willoughby, OH 44094-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0903311 | (05) | OH |
F31554 | (02) |