Provider Demographics
NPI:1194701565
Name:OKUN-LANGLAIS, AUDREY (DO)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:OKUN-LANGLAIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BARNARD LN
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6714
Mailing Address - Country:US
Mailing Address - Phone:207-502-7074
Mailing Address - Fax:207-502-7079
Practice Address - Street 1:26 BARNARD LN
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6714
Practice Address - Country:US
Practice Address - Phone:207-502-7074
Practice Address - Fax:207-502-7079
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1289207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME275120099Medicaid
NH30005596OtherEDS NH MEDICAID
ME610009002OtherCIGNA
NH30005596Medicaid
ME099517OtherANTHEM
ME080104234OtherMEDICARE RR
MEE35303OtherHARVARD
ME080104234OtherMEDICARE RR
ME099517OtherANTHEM
ME610009002OtherCIGNA