Provider Demographics
NPI:1295957488
Name:EDWARD P. LANGLOW MD APMC
Entity type:Organization
Organization Name:EDWARD P. LANGLOW MD APMC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:P
Authorized Official - Last Name:LANGLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:985-792-1141
Mailing Address - Street 1:804 HEAVENS DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-2890
Mailing Address - Country:US
Mailing Address - Phone:985-792-1141
Mailing Address - Fax:985-792-1171
Practice Address - Street 1:804 HEAVENS DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-2890
Practice Address - Country:US
Practice Address - Phone:985-792-1141
Practice Address - Fax:985-792-1171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX IDENTIFICATION
LA5CR08Medicare ID - Type UnspecifiedMEDICARE