Jack C Lane (NPI# 1528037793, PAC ID# 2466357900) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1528037793 |
| PAC ID by PECOS | 2466357900 |
| Professional Enrollment ID | I20031205000767 |
| Full Name | Jack C Lane |
| Organization Legal Name | AMERICAN SPECIALTY PHYSICIANS GROUP INC |
| Address |
173 E Webster St Colusa CA 95932-2949 |
| Phone Number | 5306190375 |
| Gender | M |
| Credential | DO |
| Medical School | KIRKSVILLE COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1993 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | EMERGENCY MEDICINE |
| Group Practice PAC ID | 6103198460 |
| Number of Group Practice Members | 19 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 051311 | ORCHARD HOSPITAL |
| 051306 | GLENN MEDICAL CENTER |
| 050039 | ENLOE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 173 E Webster St, Colusa, CA 95932-2949 | 5306190375 | AMERICAN SPECIALTY PHYSICIANS GROUP INC |
| 240 Spruce St, Gridley, CA 95948-2216 | ORCHARD HOSPITAL | |
| 284 Spruce St, Gridley, CA 95948-2216 | 5308469080 | ORCHARD HOSPITAL |
| Organization Legal Name | AMERICAN SPECIALTY PHYSICIANS GROUP INC |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Fredric De Picciotto | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Gregory S Ishimoto | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Jayesh R Shah | Family Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Adrian L De La Torre Jr. | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Kenneth P Moses | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Tanya L Brown | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Gregory M Taylor | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Beth R Keegstra | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Jeremy D Martinez | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| David H Dempsey | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Street Address |
173 E WEBSTER ST |
| City | COLUSA |
| State | CA |
| Zip | 95932-2949 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Fredric De Picciotto | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Gregory S Ishimoto | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Jayesh R Shah | Family Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Adrian L De La Torre Jr. | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Kenneth P Moses | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Tanya L Brown | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Gregory M Taylor | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Beth R Keegstra | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Jeremy D Martinez | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| David H Dempsey | Emergency Medicine | American Specialty Physicians Group Inc | 173 E Webster St, Colusa, CA 95932-2949 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bradley R Baker | Optometry | 516 Jay St, Colusa, CA 95932-2436 | |
| Kerri A Bartlett | Family Medicine | Ampla Health | 555 Fremont St, Colusa, CA 95932-2534 |
| Richard A Rinzler | Chiropractic | 412 4th St, Colusa, CA 95932-2602 | |
| Dana Wolucka | Nurse Practitioner | 717 Bridge St, Colusa, CA 95932-2851 | |
| Emily A Houston | Physical Therapy | Western Physical Therapy, Inc. | 844 Bridge St C, Colusa, CA 95932-2867 |
| Donald R Baas | Physical Therapy | Western Physical Therapy, Inc. | 844 Bridge St C, Colusa, CA 95932-2867 |
| Matthew Bennion | Physical Therapy | Western Physical Therapy, Inc. | 844 Bridge St C, Colusa, CA 95932-2867 |
| John J Kvale | Physical Therapy | Western Physical Therapy, Inc. | 844 Bridge St C, Colusa, CA 95932-2867 |
| Susan K Madson | Clinical Social Worker | County of Colusa | 162 E Carson St, Colusa, CA 95932-2880 |
| Brizia G Tafolla Martinez | Clinical Social Worker | County of Colusa | 162 E Carson St, Colusa, CA 95932-2880 |
| Find all physicians in zip 95932 | |||
| City | COLUSA |
| Zip Code | 95932 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | COLUSA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Jack C Lane.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.