Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 028181 | GA |
NPI | 1104882091 |
---|---|
Provider Name | David A Langford |
First Address | Atlanta, GA 30368-6156 |
Second Address | Lawrenceville, GA 30046-3367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 15/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000482666B | (05) | GA |
00482666A | (05) | GA |
026201 | BCBS EDI# (01) | GA |
330003440 | RRMEDICARE (01) | GA |
E88697 | (02) | GA |