Provider Demographics
NPI:1396733085
Name:LANG, JOHN B (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:LANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 W TILGHMAN ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9130
Mailing Address - Country:US
Mailing Address - Phone:484-866-9583
Mailing Address - Fax:610-366-1147
Practice Address - Street 1:4905 W TILGHMAN ST
Practice Address - Street 2:SUITE 250
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9130
Practice Address - Country:US
Practice Address - Phone:484-866-9583
Practice Address - Fax:610-366-1147
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004022L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0992326OtherKHKP CENTRAL
PA094878OtherHIGHMARK
PA0000000108357OtherTHREE RIVERS
PA0006226910003Medicaid
PA0050722000OtherINDEP. BLUE CROSS
PA1039272OtherKEYSTONE MERCY
PA00622691OtherGATEWAY
PA1039272OtherAMERIHEALTH MERCY
PA0006226910003Medicaid
PA0000000108357OtherTHREE RIVERS
PA050045117Medicare PIN