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Individual

DR. GORDON LANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
333 N 14TH ST, WAKEENEY, KS 67672-3000
(785) 743-2124
Mailing address
300 HAZEL AVE, WAKEENEY, KS 67672-1538

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
04-20739
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104716
BCBS WFCC RHC
KS
01
105315
BCBS EFCC RHC
KS
Enumeration date
08/21/2006
Last updated
07/09/2007
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