Individual
JOHN ANTHONY LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2149 VALLEYGATE DR STE 201, FAYETTEVILLE, NC 28304-3668
(910) 728-4410
Mailing address
109 CASTLEBAY DR, SANFORD, NC 27332-6272
(910) 725-9256
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08114
NC
363A00000X
Physician Assistant
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Other
Enumeration date
10/01/2009
Last updated
07/27/2022
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