Individual
LANETTE RICKBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1447 HARPER STREET MEDICAL OFFICE BUILDING SUITE 4G, AUGUSTA, GA 30912-5703
(706) 721-3042
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(800) 782-8581
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
101113
GA
208800000X
Urology Physician
20791
NV
208800000X
Urology Physician
83316-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2016
Last updated
04/18/2025
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