Individual
JESSICA LEIGH LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
120 N EAGLE CREEK DR STE 102, LEXINGTON, KY 40509-1827
(859) 629-7140
(859) 629-7137
Mailing address
120 N EAGLE CREEK DR STE 102, LEXINGTON, KY 40509-1827
(859) 629-7140
(859) 629-7137
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
50404
KY
207Y00000X
Otolaryngology Physician
T-2561
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100472170
—
KY
Enumeration date
06/29/2012
Last updated
07/21/2022
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