Individual
FORREST JAMES LANE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2406 BELLEVUE RD, DUBLIN, GA 31021-2842
(478) 275-4740
(478) 275-0533
Mailing address
PO BOX 1889, 2406 BELLEVUE RD STE 22, DUBLIN, GA 31040-1889
(478) 275-4740
(478) 275-0533
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
34641
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
34641
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00473316F
—
GA
Enumeration date
11/09/2005
Last updated
06/14/2024
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