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Individual

ROBERT CLINE LANE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1001 TOWSON AVE, ER DEPT., FORT SMITH, AR 72901-4921
(479) 441-5011
(405) 749-4561
Mailing address
4401 W MEMORIAL RD, SUITE 121, OKLAHOMA CITY, OK 73134-1785
(405) 751-4664
(405) 749-4561

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E4459
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
158056001
AR
05
200059400A
OK
Enumeration date
03/31/2006
Last updated
10/10/2008
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