Provider Demographics
NPI:1861590358
Name:LANEY, SAMUEL KEITH II (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:KEITH
Last Name:LANEY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:918-499-4855
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:300 ROCKEFELLER DR
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-5075
Practice Address - Country:US
Practice Address - Phone:918-502-1900
Practice Address - Fax:918-494-6303
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036163297208100000X
MN57430208100000X
IN01083262208100000X
CO44994208100000X
OK35567208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO10603719Medicaid
WY123552400Medicaid
P00382506OtherRAILROAD MEDICARE
COLA801107OtherANTHEM BCBS
COCOA106288Medicare PIN
COLA801107OtherANTHEM BCBS