Healthcare Provider Details

I. General information

NPI: 1023603271
Provider Name (Legal Business Name): LANGE ORTHOPAEDICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1962 1ST AVE NE STE A
CEDAR RAPIDS IA
52402-5330
US

IV. Provider business mailing address

1962 1ST AVE NE STE A
CEDAR RAPIDS IA
52402-5330
US

V. Phone/Fax

Practice location:
  • Phone: 319-449-4763
  • Fax:
Mailing address:
  • Phone: 319-449-4763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CASSANDRA LANGE
Title or Position: MD/OWNER
Credential:
Phone: 319-449-4763