Provider Demographics
NPI:1134120132
Name:ORLANG, LAVERN E (MD)
Entity Type:Individual
Prefix:
First Name:LAVERN
Middle Name:E
Last Name:ORLANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:VERN
Other - Middle Name:E
Other - Last Name:ORLANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:501 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-2837
Mailing Address - Country:US
Mailing Address - Phone:330-385-1116
Mailing Address - Fax:330-385-1552
Practice Address - Street 1:501 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2837
Practice Address - Country:US
Practice Address - Phone:330-385-1116
Practice Address - Fax:330-385-1552
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.051642207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0057290000Medicaid
OHH324240Medicare PIN
OH0567721Medicare PIN