Provider Demographics
NPI:1902871627
Name:LANGFORD, TIMOTHY DEAN (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:DEAN
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 251420
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72225-1420
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:1300 CENTERVIEW DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4349
Practice Address - Country:US
Practice Address - Phone:501-219-8900
Practice Address - Fax:501-537-1875
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC7498208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR340010631OtherRAILROAD MEDICARE
AR115717001Medicaid