Provider Demographics
NPI:1144221409
Name:LANG, JOHN PAUL (DC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PAUL
Last Name:LANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8459 US HIGHWAY 42
Mailing Address - Street 2:SUITE E
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-8350
Mailing Address - Country:US
Mailing Address - Phone:859-283-5070
Mailing Address - Fax:859-283-5071
Practice Address - Street 1:8459 US HIGHWAY 42
Practice Address - Street 2:SUITE E
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-8350
Practice Address - Country:US
Practice Address - Phone:859-283-5070
Practice Address - Fax:859-283-5071
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000216497OtherANTHEM
KY1193091OtherCAA
KYKY675COtherHUMONA
KY7324268OtherAETNA
KY85002160Medicaid
KYU90170Medicare UPIN