Provider Demographics
NPI:1659361541
Name:LANGLEY, DANIEL W (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:W
Last Name:LANGLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 E 81ST ST
Mailing Address - Street 2:100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4556
Mailing Address - Country:US
Mailing Address - Phone:918-250-2020
Mailing Address - Fax:918-250-2020
Practice Address - Street 1:10010 E. 81ST ST
Practice Address - Street 2:100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4558
Practice Address - Country:US
Practice Address - Phone:918-250-2020
Practice Address - Fax:918-250-2020
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4088207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200014170AMedicaid
OK1418813OtherAETNA HMO
OK7736868OtherAETNA
OKP00373953OtherRAILROAD MEDICARE
OK7736868OtherAETNA
OK245703901Medicare PIN
H93946Medicare UPIN