Provider Demographics
NPI:1447233168
Name:LANEY, ROBERT F (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:LANEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 S DOBSON RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5605
Mailing Address - Country:US
Mailing Address - Phone:480-728-3753
Mailing Address - Fax:480-728-3305
Practice Address - Street 1:475 S DOBSON RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5605
Practice Address - Country:US
Practice Address - Phone:480-728-3753
Practice Address - Fax:480-728-3305
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ22620207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ180609Medicaid
AZP00277661OtherRAILROAD MEDICARE
AZ105609Medicare ID - Type Unspecified
F91110Medicare UPIN