Individual
MR. RICHARD THOMAS LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
215 MARION AVE, MCCOMB, MS 39648-2705
(601) 249-5500
(601) 249-1709
Mailing address
1210 PARKLANE RD, APT 7D, MCCOMB, MS 39648-4904
(601) 916-2786
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R861734
MS
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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