Individual
DR. JASON E. LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 390-3600
(904) 390-3550
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
2080P0214X
Pediatric Pulmonology Physician
Primary
ME96140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2757877000
—
FL
05
—
365628151A
—
GA
Enumeration date
08/10/2006
Last updated
09/23/2011
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