Provider Demographics
NPI:1780682682
Name:LANGFORD, JOHN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:10300 N ILLINOIS ST
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46290-1166
Mailing Address - Country:US
Mailing Address - Phone:317-817-1976
Mailing Address - Fax:317-817-1737
Practice Address - Street 1:10300 N ILLINOIS ST
Practice Address - Street 2:SUITE 2020
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46290-1166
Practice Address - Country:US
Practice Address - Phone:317-817-1976
Practice Address - Fax:317-817-1737
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2024-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN1040840207WX0200X
ININ01040840207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100366390Medicaid
IN087020JMedicare ID - Type Unspecified
IN100366390Medicaid