Phillips, Lane R

Phillips, Lane R is an individual health care provider with primary practice located at 1125 Townpark Ave Ste 1011 , Lake Mary FL 32746-7605. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Phillips, Lane R can be contacted via phone (407) 804-9494.

Contact Information

Primary practice address
1125 Townpark Ave Ste 1011 Lake Mary FL 32746-7605
Phone: (407) 804-9494
Fax: (407) 804-9443
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 83416 South Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0S7692 Florida

Profile Details

NPI number 1659374122
LBN Legal business name Phillips, Lane R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Jul 12th, 2021 - about 4 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 1659374122 NPPES
South Carolina Other 83416 SC BOARD OF MEDICAL EXAMINERS

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