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NPI Code Detail

MEDICARE: LISA LANGMO M.D.

MEDICARE: LISA LANGMO M.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
12085R0202XDiagnostic Radiology Physician35007NE
22085R0202XDiagnostic Radiology Physician14911AWY
32085R0202XDiagnostic Radiology PhysicianDR.0071002CO

General Provider Information

NPI Number : 1508863549
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA LANGMO M.D.
Provider Business Mailing Address
First Line : 2008 CARIBOU DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-4325
Country : US
Telephone Number : 970-484-4757
Fax Number : 970-484-4759
Provider Business Practice Location Address
First Line : 1024 S LEMAY AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-3929
Country : US
Telephone Number : 970-495-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2005
Last Update Date : 06/08/2023

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