Provider Demographics
NPI:1700990371
Name:LANGLAND, CLAYTON E (PA-C)
Entity type:Individual
Prefix:MR
First Name:CLAYTON
Middle Name:E
Last Name:LANGLAND
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9525 KING ST.
Mailing Address - Street 2:MEDICAL DEPARTMENT - LIPINSKI
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-0000
Mailing Address - Country:US
Mailing Address - Phone:907-244-5272
Mailing Address - Fax:888-344-8117
Practice Address - Street 1:9525 KING ST.
Practice Address - Street 2:MEDICAL DEPARTMENT - LIPINSKI
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-0000
Practice Address - Country:US
Practice Address - Phone:907-244-5272
Practice Address - Fax:888-344-8117
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK294363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKR01161Medicare UPIN
AK160406Medicare ID - Type Unspecified