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Individual
MR. SCOTT ALAN LANGE
Active
Individual
MR. SCOTT ALAN LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
6224324-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
MA066360
PA
363AS0400X
Surgical Physician Assistant
PA00880
OR
Other
Enumeration date
12/09/2005
Last updated
06/09/2026
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