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NPI Code Detail

MEDICARE: MS. DAWN TRACY LANGLEY PA-C

MEDICARE: MS. DAWN TRACY LANGLEY PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantNC102637NC

General Provider Information

NPI Number : 1376753046
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DAWN TRACY LANGLEY PA-C
Provider Business Mailing Address
First Line : PO BOX 746724
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6724
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 103 COUNTRY CLUB DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-7603
Country : US
Telephone Number : 910-400-7002
Fax Number : 910-408-7675
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 02/26/2026

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