| James R. Lane, Iii | |
|
116 Lawrence Dr Suite 4 Columbus MS 39702-5324 | |
| (662) 329-0114 | |
| (662) 329-0114 |
| Full Name | James R. Lane, Iii |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 116 Lawrence Dr, Columbus, Mississippi |
| Authorized Official Name and Position | James Riley Lane (CLINICAL PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6623290114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| James R. Lane, Iii 116 Lawrence Dr Suite 4 Columbus MS 39702-5324 Ph: (662) 329-0114 | James R. Lane, Iii 116 Lawrence Dr Suite 4 Columbus MS 39702-5324 Ph: (662) 329-0114 |
| NPI Number | 1326379470 |
|---|---|
| Provider Enumeration Date | 01/28/2010 |
| Last Update Date | 01/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326379470 | NPI | - | NPPES |
| 08431317 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 10140 (Mississippi) | Primary |
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