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General NPI Number Information
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NPI Number | 1073221933
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Entity Type | Individual
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Provider Name | RYAN ANDREW LANGDON PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/09/2022
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 101 E WOOD ST
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City | SPARTANBURG
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State | SC
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Zip | 29303-3040
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Country | US
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Telephone | 864-560-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 25 RIVER ST APT 220
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City | GREENVILLE
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State | SC
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Zip | 29601-1658
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Country | US
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Telephone | 860-919-4156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 4684
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 7085
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License Number State | CT
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