1790881613 NPI number — DR. ROBERT VIRON LANE M.D.

Table of content: DR. ROBERT VIRON LANE M.D. (NPI 1790881613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790881613 NPI number — DR. ROBERT VIRON LANE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANE
Provider First Name:
ROBERT
Provider Middle Name:
VIRON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790881613
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
920 SW LANE ST
Provider Second Line Business Mailing Address:
SUITE #200
Provider Business Mailing Address City Name:
TOPEKA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66606-1543
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-233-0500
Provider Business Mailing Address Fax Number:
786-233-0660

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
920 SW LANE ST
Provider Second Line Business Practice Location Address:
SUITE #200
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66606-1543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-233-0500
Provider Business Practice Location Address Fax Number:
786-233-0660
Provider Enumeration Date:
09/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  2001027197 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Y00000X , with the licence number: 0433487 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000 . This is a "MULTIPLAN" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 1790881613 . This is a "BCBS OF KANSAS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000 . This is a "CIGNA" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000 . This is a "TRICARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000 . This is a "HUMANA/CHOICE CARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000 . This is a "INDIAN HEALTH SERVICES" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000 . This is a "PREFERRED HEALTH SYSTEMS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000 . This is a "CHILDREN'S MERCY" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 200605210A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201222 . This is a "HEALTH PARTNERS OF KANSAS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000 . This is a "CENTURY HEALTH SOLUTIONS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: 000 . This is a "COVENTRY" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".




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