Provider Demographics
NPI:1326018839
Name:LANEY, PHILLIP LEONARD (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:LEONARD
Last Name:LANEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-539-4080
Mailing Address - Fax:256-539-4099
Practice Address - Street 1:930 FRANKLIN ST SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4312
Practice Address - Country:US
Practice Address - Phone:256-539-4080
Practice Address - Fax:256-539-4099
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13405207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL112223Medicaid
AL112225Medicaid
AL112229Medicaid
AL51033798OtherBCBS
AL112219Medicaid
4279644OtherAETNA
AL515-98652OtherBCBS
ALP00765573OtherRAILROAD MEDICARE
AL000033798Medicaid
TN0173786OtherBCBS
AL112233Medicaid
AL510-49266OtherBCBS
AL515-98654OtherBCBS
AL510-49264OtherBCBS
060037258OtherRAILROAD MEDICARE
AL112239Medicaid
25-10262OtherUNITED HEALTHCARE
AL510-49265OtherBCBS
AL515-98653OtherBCBS
AL510-49265OtherBCBS
AL510-49264OtherBCBS
AL112223Medicaid
AL112225Medicaid