Provider Demographics
NPI:1568917037
Name:CHRIS A LANE DO INC PC
Entity Type:Organization
Organization Name:CHRIS A LANE DO INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-343-7602
Mailing Address - Street 1:4505 BLACKBERRY RUN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6157
Mailing Address - Country:US
Mailing Address - Phone:405-470-6767
Mailing Address - Fax:
Practice Address - Street 1:4505 BLACKBERRY RUN
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6157
Practice Address - Country:US
Practice Address - Phone:405-343-7602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3863207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty