Provider Demographics
NPI:1376623744
Name:LANGSTON, CATHERINE J (DO)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:J
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:620 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2926
Practice Address - Country:US
Practice Address - Phone:870-365-2000
Practice Address - Fax:870-262-6088
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN-8357207P00000X
ARN8357207P00000X
IN02004363A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5J153OtherAR BLUE CROSS
AR123972003Medicaid
AR123972003Medicaid
5J153Medicare PIN