Individual
DR. JUSTIN MICHAEL DELANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1215 N BEAVER ST, FLAGSTAFF, AZ 86001-3126
(928) 773-2200
(928) 773-2300
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
006389
AZ
2084N0400X
Neurology Physician
56301
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
927239
—
AZ
Enumeration date
08/30/2012
Last updated
04/02/2021
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