MEDICARE: DR. DAVID JAMES LANGFORD O.D.

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	152W00000X	Optometrist	5354587-9934	UT
2	152W00000X	Optometrist	5354587-8904	UT

General Provider Information

NPI Number	:	1255337549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JAMES LANGFORD O.D.

Provider Business Mailing Address
First Line	:	PO BOX 1310
Second Line	:
City	:	RIVERTON
State	:	WY
Zip	:	82501-0158
Country	:	US
Telephone Number	:	307-856-8094
Fax Number	:	307-856-1630

Provider Business Practice Location Address
First Line	:	14 GREAT PLAINS RD
Second Line	:
City	:	ARAPAHOE
State	:	WY
Zip	:	82510
Country	:	US
Telephone Number	:	307-856-8094
Fax Number	:	307-856-1630

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	03/07/2023

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