| Roger B Lane Jr, MD | |
|
3011 Hampton Ave, Brunswick, GA 31520-4264 | |
| (912) 261-2669 | |
| (912) 261-0561 |
| Full Name | Roger B Lane Jr |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 31 Years |
| Location | 3011 Hampton Ave, Brunswick, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639154834 | NPI | - | NPPES |
| 000828781A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 041451 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southeast Georgia Health System- Brunswick Campus | Brunswick, GA | Hospital |
| Southeast Georgia Health System -- Camden Campus | Saint marys, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southeastern Pathology Associates Pc | 5890781371 | 45 |
| Entity Name | Southeastern Pathology Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992963268 PECOS PAC ID: 5890781371 Enrollment ID: O20130606000449 |
| Mailing Address | Practice Location Address |
|---|---|
| Roger B Lane Jr, MD Po Box 30309, Charleston, SC 29417-0309 Ph: (843) 554-9300 | Roger B Lane Jr, MD 3011 Hampton Ave, Brunswick, GA 31520-4264 Ph: (912) 261-2669 |
Dr. Yumi Angerica Kojima, D.O. Pathology Medicare: Accepting Medicare Assignments Practice Location: 203 Indigo Dr, Brunswick, GA 31525 Phone: 912-261-2669 Fax: 912-261-0561 | |
Ningxing Chen, D.O. Pathology Medicare: Accepting Medicare Assignments Practice Location: 203 Indigo Dr, Brunswick, GA 31525 Phone: 912-261-2669 | |
Rena Burlingame Rengo, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 203 Indigo Dr, Brunswick, GA 31525 Phone: 912-261-2669 | |
Shyamala Yennam, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 203 Indigo Dr, Brunswick, GA 31525 Phone: 912-261-2669 Fax: 912-261-0561 | |
Janet O. Hon, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3011 Hampton Ave, Sepa, Brunswick, GA 31520 Phone: 912-261-2669 Fax: 912-261-0561 | |
Carolyn Kinzer-bezanson Wall, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 203 Indigo Drive, Southeastern Pathology Associates, Pc, Brunswick, GA 31525 Phone: 912-279-1900 Fax: 912-261-0753 | |
Rose P Draviam, M. D. Pathology Medicare: Not Enrolled in Medicare Practice Location: 3011 Hampton Ave, Brunswick, GA 31520 Phone: 912-261-2669 Fax: 912-261-0561 |