Provider Demographics
NPI:1750378097
Name:LANIER, JAMES F (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:LANIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19643 TENADA AVE
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567
Mailing Address - Country:US
Mailing Address - Phone:907-565-8055
Mailing Address - Fax:907-565-8066
Practice Address - Street 1:19643 TENADA AVE
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567
Practice Address - Country:US
Practice Address - Phone:907-562-2211
Practice Address - Fax:907-565-8066
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1094207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1094Medicaid
AKMD1094Medicaid
AKKOOWCKFZAMedicare ID - Type Unspecified