Lane Lamar Wall, M.D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

182257-1205 Issued in UT

Practice address

BLDG 813 Room 104
Fort Carson, CO 80913

Phone

(719) 524-7350

NPI assigned

Aug 18, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1811989676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 813 ROOM 104",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "719-524-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 813 ROOM 104",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "719-524-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "LANE",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "UT",
            "license": "182257-1205",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "UT",
            "license": "182257-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Viramontes Jr., DMD
• Alexander Richard Vosberg, PA
• Casey Walker
• Marc Robert Walker, M.D.
• Jessica Ruth Walkup, CRNA
• Kristin Renee Wallace, PHARM.D.
• Deanna Lorraine Wallis, REGISTERED NURSE
• Charles K. Walters, DHSC, OTR/L, CHT
• Lucas M. Wangerin, PA-C
• Charles M Warnement, CRNA

• Occupational Medicine Physician in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Occupational Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.