Individual
DR. LANE HOLLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15790 PAUL VEGA MD DR, HAMMOND, LA 70403-1436
(985) 230-3066
(985) 230-6652
Mailing address
2328 VESTAL AVE, LOS ANGELES, CA 90026-2058
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
331002
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
LA
Other
Enumeration date
03/27/2020
Last updated
06/30/2023
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