Basic Information
| Provider Information | |||||||||
| NPI: | 1750378097 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LANIER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19643 TENADA AVE | ||||||||
| Address2: | |||||||||
| City: | CHUGIAK | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075658055 | ||||||||
| FaxNumber: | 9075658066 | ||||||||
| Practice Location | |||||||||
| Address1: | 19643 TENADA AVE | ||||||||
| Address2: | |||||||||
| City: | CHUGIAK | ||||||||
| State: | AK | ||||||||
| PostalCode: | 99567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9075622211 | ||||||||
| FaxNumber: | 9075658066 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2005 | ||||||||
| LastUpdateDate: | 08/30/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 1094 | AK | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | MD1094 | 05 | AK | MEDICAID |