Healthcare Provider Details

I. General information

NPI: 1760451058
Provider Name (Legal Business Name): STEVEN LAWRENCE LANGDON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19849 STATELINE RD
LAWRENCEBURG IN
47025-7791
US

IV. Provider business mailing address

PO BOX 635283
CINCINNATI OH
45263-5283
US

V. Phone/Fax

Practice location:
  • Phone: 812-496-8774
  • Fax: 812-537-9434
Mailing address:
  • Phone: 812-496-8774
  • Fax: 812-537-9434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01058166A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: