Individual
DR. BRANDON COLE LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
340 W 10TH ST STE 6200, INDIANAPOLIS, IN 46202-3082
(317) 274-8157
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01084142A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11017247A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300039821
—
IN
Enumeration date
06/25/2013
Last updated
05/06/2022
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