Provider Demographics
NPI:1003815937
Name:LANG, JOHN M (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:
Practice Address - Street 1:1 TOWN SQUARE BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-5006
Practice Address - Country:US
Practice Address - Phone:828-654-5012
Practice Address - Fax:828-654-5014
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00682107OtherMEDICARE RAILROAD
NC89129A8Medicaid
NC129A8OtherBCBS
H39787Medicare UPIN
NC2285021AMedicare PIN