Provider Demographics
NPI:1477395655
Name:SEBES, LANE G
Entity type:Individual
Prefix:
First Name:LANE
Middle Name:G
Last Name:SEBES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-4201
Mailing Address - Country:US
Mailing Address - Phone:785-238-4711
Mailing Address - Fax:
Practice Address - Street 1:222 N 6TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4956
Practice Address - Country:US
Practice Address - Phone:785-706-9833
Practice Address - Fax:785-530-5379
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-1177581835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist