Derrick F Lane (NPI# 1124079447, PAC ID# 3577502186) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1124079447 |
| PAC ID by PECOS | 3577502186 |
| Professional Enrollment ID | I20050503000132 |
| Full Name | Derrick F Lane |
| Organization Legal Name | JASPER HEALTH SERVICES INC. |
| Address |
898 College St Jasper Memorial Hosp Monticello GA 31064-1261 |
| Phone Number | 7064680988 |
| Gender | M |
| Credential | MD |
| Medical School | MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE |
| Graduation Year | 2001 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 7214901230 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 111303 | JASPER MEMORIAL HOSPITAL |
| 110018 | PIEDMONT NEWTON HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 898 College St, Jasper Memorial Hosp, Monticello, GA 31064-1261 | 7064680988 | JASPER HEALTH SERVICES INC. |
| Organization Legal Name | JASPER HEALTH SERVICES INC. |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth Copelan Wood | Physician Assistant | Jasper Health Services Inc. | 898 College St, Jasper Memorial Hosp, Monticello, GA 31064-1261 |
| Ashley S Nordstrom | Physician Assistant | Jasper Health Services Inc. | 898 College St, Jasper Memorial Hosp, Monticello, GA 31064-1261 |
| Nicole E Ross | Internal Medicine | Jasper Health Services Inc. | 898 College St, Jasper Memorial Hosp, Monticello, GA 31064-1261 |
| Nataliya A Kubasova | Family Medicine | Jasper Health Services Inc. | 898 College St, Jasper Memorial Hosp, Monticello, GA 31064-1261 |
| Street Address |
898 COLLEGE ST JASPER MEMORIAL HOSP |
| City | MONTICELLO |
| State | GA |
| Zip | 31064-1261 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Elizabeth Copelan Wood | Physician Assistant | Jasper Health Services Inc. | 898 College St, Jasper Memorial Hosp, Monticello, GA 31064-1261 |
| Ashley S Nordstrom | Physician Assistant | Jasper Health Services Inc. | 898 College St, Jasper Memorial Hosp, Monticello, GA 31064-1261 |
| Nicole E Ross | Internal Medicine | Jasper Health Services Inc. | 898 College St, Jasper Memorial Hosp, Monticello, GA 31064-1261 |
| Nataliya A Kubasova | Family Medicine | Jasper Health Services Inc. | 898 College St, Jasper Memorial Hosp, Monticello, GA 31064-1261 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert L Elwell Jr | Optometry | 673 W Washington St, Monticello, GA 31064-1371 | |
| Lyndsy A Holman | Chiropractic | 972 College St, Monticello, GA 31064-2107 | |
| Anthony M Omeara | Family Medicine | Venture Medical Associates LLC | 545 Venture Ct, Monticello, GA 31064-7788 |
| City | MONTICELLO |
| Zip Code | 31064 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MONTICELLO + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Derrick F 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.