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Individual

EDWARD LANGSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
504 W. CAMP STREET, LEBANON, IN 46052-1647
(765) 482-7005
Mailing address
4818 W HARRISBURG CT, NEW PALESTINE, IN 46163-8546

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01026184
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080159547
RAILROAD MEDICARE
IN
05
100254030
IN
Enumeration date
11/01/2006
Last updated
02/23/2018
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