Provider Demographics
NPI:1023306388
Name:LANE, ASHLEY MICHELE (DO)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MICHELE
Last Name:LANE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1195 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-8095
Mailing Address - Country:US
Mailing Address - Phone:417-777-8131
Mailing Address - Fax:417-777-8892
Practice Address - Street 1:1195 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-8095
Practice Address - Country:US
Practice Address - Phone:417-777-8131
Practice Address - Fax:417-777-8892
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101019403207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology