Provider Demographics
NPI:1326006347
Name:LANG, JASON E (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:E
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-2652
Mailing Address - Country:US
Mailing Address - Phone:207-307-8902
Mailing Address - Fax:207-307-8911
Practice Address - Street 1:78 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-2652
Practice Address - Country:US
Practice Address - Phone:207-307-8902
Practice Address - Fax:207-307-8911
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD29110207X00000X
NC2007-00480207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC147CNOtherBCBS
NC201088OtherMEDCOST
WV3810009590Medicaid
SCQ0048KMedicaid
NC5907250Medicaid
NC810624OtherPARTNERS
9489097OtherAETNA
VA1326006347Medicaid
2075086Medicare PIN