Provider Demographics
NPI:1891270393
Name:DR. JASON R LANEY, PC
Entity Type:Organization
Organization Name:DR. JASON R LANEY, PC
Other - Org Name:LANEY INTERNAL MEDICINE GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-375-3095
Mailing Address - Street 1:PO BOX 730
Mailing Address - Street 2:
Mailing Address - City:HAZLEHURST
Mailing Address - State:GA
Mailing Address - Zip Code:31539-0730
Mailing Address - Country:US
Mailing Address - Phone:912-375-3095
Mailing Address - Fax:912-375-0064
Practice Address - Street 1:209 S TALLAHASSEE ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:GA
Practice Address - Zip Code:31539-6025
Practice Address - Country:US
Practice Address - Phone:912-375-3095
Practice Address - Fax:912-375-0064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care