Individual
DR. CARL LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1123 BRENT RD, BARNESVILLE, GA 30204-3611
(770) 584-4355
Mailing address
1123 BRENT RD, BARNESVILLE, GA 30204-3611
(770) 584-4355
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
20330
GA
Other
Enumeration date
03/05/2014
Last updated
03/05/2014
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