Provider Demographics
NPI:1457391229
Name:LANGSTON, SHERON JOAN (MD)
Entity Type:Individual
Prefix:
First Name:SHERON
Middle Name:JOAN
Last Name:LANGSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4323 CAROTHERS PKWY
Mailing Address - Street 2:SUITE 503
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5914
Mailing Address - Country:US
Mailing Address - Phone:615-595-7718
Mailing Address - Fax:615-595-7768
Practice Address - Street 1:4323 CAROTHERS PKWY
Practice Address - Street 2:SUITE 503
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5914
Practice Address - Country:US
Practice Address - Phone:615-595-7718
Practice Address - Fax:615-595-7768
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD25008207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1504387Medicaid
F75715Medicare UPIN
TN30812191Medicare PIN