Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 53846 | TN |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 53846 | TN |
NPI | 1225323462 |
---|---|
Provider Name | Justin William Langan |
First Address | Nashville, TN 37204-3708 |
Second Address | Nashville, TN 37205-2098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2011 |
Last Update Date | 27/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q022795 | (05) | TN |