Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 97587 | OK |
NPI | 1114409331 |
---|---|
Provider Name | Samantha Carol Langley |
First Address | Oklahoma City, OK 73104-5418 |
Second Address | Oklahoma City, OK 73104-5418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2018 |
Last Update Date | 04/09/2018 |