Healthcare Provider Details

I. General information

NPI: 1992729826
Provider Name (Legal Business Name): MARTIN B LANGFORD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 W EUGIE AVE STE 106
GLENDALE AZ
85304-1256
US

IV. Provider business mailing address

7373 N SCOTTSDALE ROAD BUILDING E- SUITE 100
SCOTTSDALE AZ
85253
US

V. Phone/Fax

Practice location:
  • Phone: 602-978-6255
  • Fax: 602-564-9286
Mailing address:
  • Phone: 480-941-1211
  • Fax: 623-478-1534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number21575
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number21575
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: