Provider Demographics
NPI:1942303565
Name:LANIER, ROBERT JAMES (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:LANIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-2219
Mailing Address - Country:US
Mailing Address - Phone:602-833-3199
Mailing Address - Fax:602-833-3190
Practice Address - Street 1:901 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-2219
Practice Address - Country:US
Practice Address - Phone:602-833-3199
Practice Address - Fax:602-833-3190
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5947111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1942003OtherFIRST HEALTH
623123OtherACN
0007603755OtherAETNA
1029764OtherAMERICAN SPECIALTY HEALTH
AZ2165442011OtherUNITED HEALTHCARE
AZAZ0944650OtherBLUE CROSS/BLUE SHIELD
623123OtherACN