Provider Demographics
NPI:1851435879
Name:LANGDON, RICHARD NEAL SR (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:NEAL
Last Name:LANGDON
Suffix:SR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 S RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-1143
Mailing Address - Country:US
Mailing Address - Phone:570-822-4848
Mailing Address - Fax:570-822-4879
Practice Address - Street 1:250 S RIVER ST
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-1143
Practice Address - Country:US
Practice Address - Phone:570-822-4848
Practice Address - Fax:570-822-4879
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-002044L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA077910OtherFIRST PRIORITY
PA567086OtherBC BS AC
PA4408741OtherAETNA
PA0006453910001Medicaid
PA143976Medicare ID - Type Unspecified