Provider Demographics
NPI:1164724407
Name:JAMES H. LANGENKAMP, M.D., S.C.
Entity Type:Organization
Organization Name:JAMES H. LANGENKAMP, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HALBERG
Authorized Official - Last Name:LANGENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-332-9898
Mailing Address - Street 1:575 W RIVER WOODS PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1003
Mailing Address - Country:US
Mailing Address - Phone:414-332-9898
Mailing Address - Fax:414-332-6849
Practice Address - Street 1:575 W RIVER WOODS PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53212-1003
Practice Address - Country:US
Practice Address - Phone:414-332-9898
Practice Address - Fax:414-332-6849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30332400Medicaid
WI000001680Medicare PIN
WI30332400Medicaid