Individual
DR. DAVID L LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M,D.
Contact information
Practice address
BUILDING 160 DOGWOOD AVENUE, MOUNTAIN HOME, TN 37684
(423) 926-1171
(423) 979-3507
Mailing address
197 OVERHILL DR, JONESBOROUGH, TN 37659-4347
(423) 926-1171
(423) 979-3507
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD11896
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101028936
STATE LICENSE
VA
01
—
MD0000011896
STATE LICENSE
TN
Enumeration date
05/16/2006
Last updated
07/08/2007
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