Lane, Debra A

Lane, Debra A is an individual health care provider with primary practice located at 657 E Broadway Blvd Healthstar Physicians Ste C, Jefferson City TN 37760. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Lane, Debra A can be contacted via phone (865) 475-9062.

Contact Information

Primary practice address
657 E Broadway Blvd Healthstar Physicians Ste C Jefferson City TN 37760
Phone: (865) 475-9062
Fax: (865) 475-9063
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD40163 Tennessee

Profile Details

NPI number 1740231646
LBN Legal business name Lane, Debra A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 15th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740231646 NPPES
Tennessee MEDICAID 3333808

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