Provider Demographics
NPI:1679548549
Name:LANEY, WILLIAM HOWARD (MD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:HOWARD
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 1:1431 PREMIER DRIVE
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001
Mailing Address - Country:US
Mailing Address - Phone:507-386-6600
Mailing Address - Fax:507-625-5971
Practice Address - Street 1:1431 PREMIER DRIVE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001
Practice Address - Country:US
Practice Address - Phone:507-386-6600
Practice Address - Fax:507-625-5971
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28750207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0900366OtherMEDICA, MANKATO
MN0904465OtherMEDICA, FARIBAULT
MN257372500Medicaid
MN410940705H004OtherTRICARE/WPS
MN983181004380OtherPREFERRED ONE
MNHP13773OtherHEALTH PARTNERS
MN41373LAOtherBCBS MN
MN0901618OtherMEDICA, WASECA
MN0912492OtherMEDICA, NORTHFIELD
MN106174C572OtherUCARE MN
MND80078Medicare UPIN
MN983181004380OtherPREFERRED ONE
MN200010212Medicare ID - Type UnspecifiedPALMETTO GBA, RR MC