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Individual

DR. MINDY KATHRYN LANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
Mailing address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
02008209A
IN
208600000X
Surgery Physician
5101013104
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02008209A
IN LICENSE
IN
01
02008209B
CSR
IN
01
0M21440055
MEDICARE PLUS BLUE
MI
01
1020388
CURANET
MI
01
200000002269
PHP
MI
05
4311822
MI
05
4911173
MI
01
P00456403
RAILROAD MEDICARE
MI
Enumeration date
11/02/2005
Last updated
01/14/2025
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