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Individual

KELLEY MAREE LANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2633 CENTENNIAL BLVD, SUITE 100, TALLAHASSEE, FL 32308-0585
(850) 431-5404
(850) 431-4794
Mailing address
2633 CENTENNIAL BLVD, SUITE 100, TALLAHASSEE, FL 32308-0585
(850) 431-5404
(850) 431-4794

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME104789
FL
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
ME104789
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001212100
FL
01
146KJ
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/01/2007
Last updated
10/04/2018
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