Healthcare Provider Details

I. General information

NPI: 1689056822
Provider Name (Legal Business Name): TRAVIS M LANGAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2015
Last Update Date: 04/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W WILSON BRIDGE RD STE 200
WORTHINGTON OH
43085
US

IV. Provider business mailing address

350 W WILSON BRIDGE RD STE 200
WORTHINGTON OH
43085-2217
US

V. Phone/Fax

Practice location:
  • Phone: 614-895-8747
  • Fax: 614-895-3246
Mailing address:
  • Phone: 614-895-8747
  • Fax: 614-895-3246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC006643
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.003870
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: