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General NPI Number Information
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NPI Number | 1417144403
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Entity Type | Organization
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Legal Business Name | EUGENE E. LANGEVIN,D.O.,P.C.
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 1531 W 32ND ST SUITE 208
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City | JOPLIN
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State | MO
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Zip | 64804-1611
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Country | US
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Telephone | 417-623-6343
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Fax | 417-623-6424
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Provider Business Mailing Address
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Address Line | 1531 W 32ND ST SUITE 208
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City | JOPLIN
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State | MO
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Zip | 64804-1611
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Country | US
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Telephone | 417-623-6343
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Fax | 417-623-6424
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Authorized Official
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Title or Position | PRACTICE MANAGER/CORPORATION SEC
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Name | MRS. JUDY A LANGEVIN
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Credential |
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Telephone | 417-623-6343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 32881
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License Number State | MO
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