Healthcare Provider Details

I. General information

NPI: 1922458033
Provider Name (Legal Business Name): ANDREA MICHELLE LANGFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 S HIGLEY RD STE 101
GILBERT AZ
85296-4777
US

IV. Provider business mailing address

655 S DOBSON RD STE 101
CHANDLER AZ
85224-5668
US

V. Phone/Fax

Practice location:
  • Phone: 480-571-1554
  • Fax:
Mailing address:
  • Phone: 480-459-2555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number009571
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: