Provider Demographics
NPI:1700293297
Name:LANG, LISA MICHELE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MICHELE
Last Name:LANG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16105 CHENAL PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4824
Mailing Address - Country:US
Mailing Address - Phone:501-217-7920
Mailing Address - Fax:501-217-7922
Practice Address - Street 1:16105 CHENAL PKWY STE B
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-4824
Practice Address - Country:US
Practice Address - Phone:501-217-7920
Practice Address - Fax:501-217-7922
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist