Healthcare Provider Details

I. General information

NPI: 1336373307
Provider Name (Legal Business Name): LANGAN PHELPS ROBBINS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL GUAM BLDG 50 FAHRENHOLT
AGANA HEIGHTS GU
96910
US

IV. Provider business mailing address

15 MOUNT TENJO AVE
SANTA RITA GU
96915-1428
US

V. Phone/Fax

Practice location:
  • Phone: 671-344-9765
  • Fax:
Mailing address:
  • Phone: 671-788-5538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0102202261
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number62286
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MB10598900
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0102202261
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25MB10598900
License Number StateNJ
# 6
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberDO-0076
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: