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General NPI Number Information
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NPI Number | 1396719415
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Entity Type | Individual
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Provider Name | JOHN ANDREW LANG M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 04/09/2013
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Provider Practice Location Address
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Address Line | 101 SOUTH MOORE AVENUE
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City | CLAREMORE
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State | OK
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Zip | 74017
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Country | US
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Telephone | 918-342-6200
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Fax | 918-342-6286
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Provider Business Mailing Address
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Address Line | 101 SOUTH MOORE AVENUE
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City | CLAREMORE
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State | OK
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Zip | 74017
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Country | US
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Telephone | 918-342-6200
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Fax | 918-342-6286
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MD071212L
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License Number State | PA
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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 | L6483
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License Number State | TX
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