Jordan Bryan Lane, DO is a medicare enrolled "Dermatology" physician in West Plains, Missouri. He went to New York College Of Osteo Medicine Of New York Institute Of Technology and graduated in 2021 and has 4 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Ozarks Medical Center and his current practice location is
1100 N Kentucky Ave, West Plains, Missouri. You can reach out to his office (for appointments etc.) via phone at
(417) 256-9111.
Jordan Bryan Lane is licensed to practice in Missouri (license number 2022025223) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1639758006.
Physician's Profile
| Full Name | Jordan Bryan Lane |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 4 Years |
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| Location | 1100 N Kentucky Ave, West Plains, Missouri |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jordan Bryan Lane attended and graduated from New York College Of Osteo Medicine Of New York Institute Of Technology in 2021
NPI Data:
- NPI Number: 1639758006
- Provider Enumeration Date: 04/05/2021
- Last Update Date: 07/06/2025
Medicare PECOS Information:
- PECOS PAC ID: 7113439894
- Enrollment ID: I20250626003000
Medical Identifiers
Medical identifiers for Jordan Bryan Lane such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1639758006 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | 2022025223 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Ozarks Medical Center | 3870491863 | 164 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jordan Bryan Lane is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Jordan Bryan Lane, DO
1100 N Kentucky Ave,
West Plains, MO 65775-2029
Ph: (417) 256-9111 | Jordan Bryan Lane, DO
1100 N Kentucky Ave,
West Plains, MO 65775-2029
Ph: (417) 256-9111 |
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