Charles A. Lane, MD

NPI #1164581468 in Maryville, Illinois

Provider Information

NPI Number: 1164581468
Entity Type: Individual
Name: Charles A. Lane, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Surgery
Credential: MD
Enumeration Date: Dec 6, 2006
Last Updated: Mar 9, 2020

Practice Location

Address: 6810 STATE ROUTE 162 STE 100
City: Maryville
State: Illinois
ZIP Code: 62062-8560
Phone: (618) 288-5711

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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