Provider Demographics
NPI:1790704583
Name:LANGHOLZ, JANICE K (MD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:K
Last Name:LANGHOLZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 2201
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9800
Mailing Address - Fax:913-588-9803
Practice Address - Street 1:2330 SHAWNEE MISSION PKWY
Practice Address - Street 2:SUITE 2201
Practice Address - City:WESTWOOD
Practice Address - State:KS
Practice Address - Zip Code:66205-2005
Practice Address - Country:US
Practice Address - Phone:913-588-9800
Practice Address - Fax:913-588-9803
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR9H78207R00000X
KS04-22476207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00407390OtherRR MEDICARE PTAN
MO204764906Medicaid
E60642Medicare UPIN
MOB941425Medicare ID - Type Unspecified
KSJ611425AMedicare PIN