Provider Demographics
NPI:1477844397
Name:THOMAS G LANG MD LLC
Entity Type:Organization
Organization Name:THOMAS G LANG MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSITIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GILMAN
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-561-5801
Mailing Address - Street 1:741 SESAME ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-6657
Mailing Address - Country:US
Mailing Address - Phone:907-561-5801
Mailing Address - Fax:
Practice Address - Street 1:741 SESAME ST STE 1B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6657
Practice Address - Country:US
Practice Address - Phone:907-561-5801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty