Provider Demographics
NPI:1295835395
Name:LANG, JEAN ANNE (DO)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:ANNE
Last Name:LANG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:ANNE
Other - Last Name:LOIUDICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:855 W MAPLE ST
Mailing Address - Street 2:STE 120
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9668
Mailing Address - Country:US
Mailing Address - Phone:330-877-6613
Mailing Address - Fax:330-877-6618
Practice Address - Street 1:855 W MAPLE ST
Practice Address - Street 2:STE 120
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-9668
Practice Address - Country:US
Practice Address - Phone:330-877-6613
Practice Address - Fax:330-877-6618
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-002323207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine