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Individual

DR. ROBERT J. LANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4500 W OAKEY BLVD, LAS VEGAS, NV 89102
(702) 873-5110
(702) 873-8093
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 216-3346
(702) 671-6883

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
006470
AZ
207Q00000X
Family Medicine Physician
02002157
IN
207Q00000X
Family Medicine Physician
Primary
DO2084
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000093781
ANTHEM NUMBER
IN
01
02002157
STATE LICENCE NUMBER
IN
05
1992758726
NV
05
200256280A
IN
01
410042917
RAIL ROAD MEDICARE
IN
01
6740
AZ LICENSE
AZ
05
675414
AZ
01
DO2084
STATE LICENSE
NV
Enumeration date
05/19/2006
Last updated
03/07/2023
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