1316263866 NPI number — DR. PATRICK MORGAN LANG MD

Table of content: DR. PATRICK MORGAN LANG MD (NPI 1316263866)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316263866 NPI number — DR. PATRICK MORGAN LANG MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LANG
Provider First Name:
PATRICK
Provider Middle Name:
MORGAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316263866
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11001 EXECUTIVE CENTER DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72211-4393
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-812-7800
Provider Business Mailing Address Fax Number:
501-812-7777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9601 BAPTIST HEALTH DRIVE
Provider Second Line Business Practice Location Address:
MEDICAL TOWER 1, SUITE 250
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-217-4910
Provider Business Practice Location Address Fax Number:
501-217-4943
Provider Enumeration Date:
04/08/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207VF0040X , with the licence number:  E-8686 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)