Provider Demographics
NPI:1942787866
Name:LANGFORD, JAMES III (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:LANGFORD
Suffix:III
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 RIBAUT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5477
Mailing Address - Country:US
Mailing Address - Phone:843-525-0045
Mailing Address - Fax:843-525-0826
Practice Address - Street 1:1076 RIBAUT RD STE 101
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5477
Practice Address - Country:US
Practice Address - Phone:843-525-0045
Practice Address - Fax:843-525-0826
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8831363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant