Provider Demographics
NPI:1639325194
Name:LANGER-KAUFMANN, JODI D (MD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:D
Last Name:LANGER-KAUFMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:D
Other - Last Name:LANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:151 SOUTHHALL LANE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:771 OLD NORCROSS RD
Practice Address - Street 2:SUITE 260
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4386
Practice Address - Country:US
Practice Address - Phone:770-962-5040
Practice Address - Fax:770-962-5056
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67671207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology