Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Mitchell D Lane Jr., PA-C

Individual provider Physician Assistant · NPI 1750522868

Mr. Mitchell D Lane Jr., PA-C is a Physician Assistant in Shreveport, Louisiana. Works from 2 locations. Licensed in Texas.

Licensed in
TX
In the registry since
2009
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

510 E Stoner Ave
Shreveport, LA 71101-4243
Phone: (318) 221-8411
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1107 E Marshall Ave, Longview, TX 75601-5602 — (903) 758-5610

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA06014 (TX)

Record details

NPI number1750522868
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 19, 2009
Last updated in NPPESMay 24, 2023
Certification dateMay 24, 2023

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