Provider Demographics
NPI:1326006347
Name:LANG, JASON E (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:E
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27102-0344
Mailing Address - Country:US
Mailing Address - Phone:336-716-2255
Mailing Address - Fax:336-716-8018
Practice Address - Street 1:2585 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-9577
Practice Address - Country:US
Practice Address - Phone:828-258-8800
Practice Address - Fax:828-651-0026
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-00480207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC147CNOtherBCBS
NC201088OtherMEDCOST
WV3810009590Medicaid
SCQ0048KMedicaid
NC5907250Medicaid
NC810624OtherPARTNERS
9489097OtherAETNA
VA1326006347Medicaid
2075086Medicare PIN