Individual
TARA R. LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35.090233
OH
208000000X
Pediatrics Physician
47705
MN
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
61572
WI
2080P0203X
Pediatric Critical Care Medicine Physician
47705
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
02/03/2006
Last updated
06/14/2016
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