Provider Demographics
NPI:1356422133
Name:LANGE, JULIE MYERS (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MYERS
Last Name:LANGE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 S 18TH ST STE 4C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2654
Mailing Address - Country:US
Mailing Address - Phone:614-224-6222
Mailing Address - Fax:614-241-5232
Practice Address - Street 1:555 S 18TH ST STE 4C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2654
Practice Address - Country:US
Practice Address - Phone:614-224-6222
Practice Address - Fax:614-241-5232
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35092753207WX0110X
OH35-092753207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2938567Medicaid
GA511I180027Medicare PIN