MEDICARE: DR. THERESE MARIE LANGO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	23786	AL
2	207RI0011X	Interventional Cardiology Physician	23786	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235136821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THERESE MARIE LANGO MD

Provider Business Mailing Address
First Line	:	1751 VETERANS DR STE 200
Second Line	:
City	:	FLORENCE
State	:	AL
Zip	:	35630-4930
Country	:	US
Telephone Number	:	256-766-2118
Fax Number	:	256-766-2101

Provider Business Practice Location Address
First Line	:	1751 VETERANS DR STE 200
Second Line	:
City	:	FLORENCE
State	:	AL
Zip	:	35630-4930
Country	:	US
Telephone Number	:	256-766-2118
Fax Number	:	256-766-2101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	04/06/2022

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Directions to “ DR. THERESE MARIE LANGO MD” Practice Location

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