Provider Demographics
NPI:1134229495
Name:LANG, THOMAS GILMAN (MD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:GILMAN
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:741 SESAME ST
Mailing Address - Street 2:1-B
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:95503-6657
Mailing Address - Country:US
Mailing Address - Phone:907-561-5801
Mailing Address - Fax:907-563-1372
Practice Address - Street 1:741 SESAME ST
Practice Address - Street 2:1-B
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:95503-6657
Practice Address - Country:US
Practice Address - Phone:907-561-5801
Practice Address - Fax:907-563-1372
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK1579208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
C97148Medicare UPIN