Individual
JAMES DOUGLAS LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
8623-1
NY
363A00000X
Physician Assistant
Primary
PA-971
ID
363A00000X
Physician Assistant
PA440
ID
363AM0700X
Medical Physician Assistant
8623-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8623-1
PA LICENSE
NY
01
—
PA-440
PA LICENSE
ID
Enumeration date
08/11/2006
Last updated
10/13/2022
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