Provider Demographics
NPI:1821449406
Name:LANGEL, JOHN WILLIAM (OD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:LANGEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 7TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-2909
Mailing Address - Country:US
Mailing Address - Phone:440-285-2020
Mailing Address - Fax:
Practice Address - Street 1:150 7TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-2909
Practice Address - Country:US
Practice Address - Phone:440-285-2020
Practice Address - Fax:440-285-8448
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006475152W00000X
NC2529152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty