Provider Demographics
NPI:1740458157
Name:DR JOHN F LANEVE JR
Entity type:Organization
Organization Name:DR JOHN F LANEVE JR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:LANEVE
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:434-845-0629
Mailing Address - Street 1:3601 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-4501
Mailing Address - Country:US
Mailing Address - Phone:434-845-0629
Mailing Address - Fax:
Practice Address - Street 1:3601 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-4501
Practice Address - Country:US
Practice Address - Phone:434-845-0629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000502152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9235108Medicaid
VA410049780OtherRAILROAD MEDICARE
VAT91822Medicare UPIN
VA3925590001Medicare NSC
VA9235108Medicaid