Provider Demographics
NPI:1710515952
Name:LANG, JACOB (PA-C)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:LANG
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:257 MCDOWELL ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2606
Mailing Address - Country:US
Mailing Address - Phone:828-258-1121
Mailing Address - Fax:828-252-6114
Practice Address - Street 1:1506 SPRING ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4071
Practice Address - Country:US
Practice Address - Phone:864-725-7900
Practice Address - Fax:864-725-7910
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-05-31
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant