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General NPI Number Information
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NPI Number | 1255343174
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Entity Type | Individual
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Provider Name | JAMES MAURICE LANGEVIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 05/26/2018
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Provider Practice Location Address
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Address Line | 118 E HASKELL ST STE D
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City | WINNEMUCCA
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State | NV
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Zip | 89445
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Country | US
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Telephone | 775-621-5699
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Fax |
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Provider Business Mailing Address
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Address Line | 124 E AYCOCK CT
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City | WEATHERFORD
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State | TX
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Zip | 76088-5018
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Country | US
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Telephone | 806-382-0684
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | K8784
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 16619
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License Number State | NV
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