Individual
DR. CHARLES ALLEN LANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2209 JEFFERSON DAVIS DR, OXFORD, MS 38655-5221
(662) 281-1115
(662) 281-1113
Mailing address
2209 JEFFERSON DAVIS DR, OXFORD, MS 38655-5221
(662) 281-1115
(662) 281-1113
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
22587
MS
207RC0000X
Cardiovascular Disease Physician
Primary
22587
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07425565
—
MS
Enumeration date
07/16/2007
Last updated
04/13/2020
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