Provider Demographics
NPI:1447426937
Name:MELISSA LANGLEY MD PC
Entity Type:Organization
Organization Name:MELISSA LANGLEY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-321-1020
Mailing Address - Street 1:250 25TH AVE N STE 307
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1624
Mailing Address - Country:US
Mailing Address - Phone:615-321-1020
Mailing Address - Fax:615-321-1002
Practice Address - Street 1:250 25TH AVE N STE 307
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1624
Practice Address - Country:US
Practice Address - Phone:615-321-1020
Practice Address - Fax:615-321-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000021981207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3377697Medicare PIN