Basic Information
| Provider Information | |||||||||
| NPI: | 1396900288 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LANEY | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | BUREN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1234 HUFFMAN MILL ROAD | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272158700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3365381234 | ||||||||
| FaxNumber: | 3365846811 | ||||||||
| Practice Location | |||||||||
| Address1: | 1123 N CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274011007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368324400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2008 | ||||||||
| LastUpdateDate: | 02/26/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 148869 | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 2011-01221 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.