Individual
LANE FALCON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1214 COOLIDGE BLVD, LAFAYETTE, LA 70503-2621
(318) 393-5075
Mailing address
102 HARPER AVE, LAFAYETTE, LA 70506-5415
(318) 393-5075
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN158972
LA
207L00000X
Anesthesiology Physician
Primary
245227
LA
Other
Enumeration date
07/22/2024
Last updated
01/14/2026
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