Provider Demographics
NPI:1063476992
Name:LANGFORD, JOSEPH SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:SCOTT
Last Name:LANGFORD
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 1:1320 MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970-8016
Mailing Address - Country:US
Mailing Address - Phone:304-793-2220
Mailing Address - Fax:304-793-2277
Practice Address - Street 1:1320 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-8016
Practice Address - Country:US
Practice Address - Phone:304-793-2220
Practice Address - Fax:304-793-2277
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000869207P00000X
WV29861207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89127EYMedicaid
NC930107011OtherRAILROAD
SCQ0086PMedicaid
NC1354MOtherBCBS
NCG80126Medicare UPIN
NC89127EYMedicaid
NC2280418AMedicare PIN