Provider Demographics
NPI:1437170388
Name:DRS. WOOD LANIER AND BOWMAN, PA
Entity Type:Organization
Organization Name:DRS. WOOD LANIER AND BOWMAN, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CURETON
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:904-356-7101
Mailing Address - Street 1:806 RIVERSIDE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-3337
Mailing Address - Country:US
Mailing Address - Phone:904-356-7101
Mailing Address - Fax:904-356-7947
Practice Address - Street 1:806 RIVERSIDE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-3337
Practice Address - Country:US
Practice Address - Phone:904-356-7101
Practice Address - Fax:904-356-7947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCK0970OtherRAILROAD MEDICARE
FL72844OtherBCBS
FLCK0970OtherRAILROAD MEDICARE
FL72844Medicare ID - Type Unspecified