Provider Demographics
NPI:1013911429
Name:LANGERT, RICHARD W (MD PC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:W
Last Name:LANGERT
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 E CARONDELET
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2117
Mailing Address - Country:US
Mailing Address - Phone:520-721-4745
Mailing Address - Fax:520-721-1932
Practice Address - Street 1:6520 E CARONDELET
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2117
Practice Address - Country:US
Practice Address - Phone:520-721-4745
Practice Address - Fax:520-721-1932
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8880207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z2067OtherHEALTHNET
AZ2318OtherPACIFICARE
AZ628850OtherAETNA
AZ3335647OtherCIGNA
AZ483714OtherUNITED HEALTHCARE
AZAZ0396310OtherBCBS
AZAZ0396310OtherBCBS