Healthcare Provider Details

I. General information

NPI: 1255337549
Provider Name (Legal Business Name): DAVID JAMES LANGFORD O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 GREAT PLAINS RD
ARAPAHOE WY
82510
US

IV. Provider business mailing address

PO BOX 1310
RIVERTON WY
82501-0158
US

V. Phone/Fax

Practice location:
  • Phone: 307-856-8094
  • Fax: 307-856-1630
Mailing address:
  • Phone: 307-856-8094
  • Fax: 307-856-1630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5354587-9934
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5354587-8904
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: