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Individual

DAVID P LANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 W OTTLEY AVE, FRUITA, CO 81521-2118
(970) 858-3900
(970) 858-2743
Mailing address
PO BOX 130, FRUITA, CO 81521-0130
(970) 858-2186
(970) 858-2208

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DR.0051636
CO
207R00000X
Internal Medicine Physician
D64974
MD
208M00000X
Hospitalist Physician
D64974
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
279281800
MD
Enumeration date
10/18/2006
Last updated
01/07/2019
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