Provider Demographics
NPI:1306252671
Name:LANGFORD, RICHARD ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALAN
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:ALAN
Other - Last Name:LANGFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:295 GREEN ST
Mailing Address - Street 2:270-D WILSON BLDG. UGA
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602-2354
Mailing Address - Country:US
Mailing Address - Phone:705-542-5338
Mailing Address - Fax:
Practice Address - Street 1:295 GREEN ST
Practice Address - Street 2:270-D WILSON BLDG. UGA
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-2354
Practice Address - Country:US
Practice Address - Phone:705-542-5338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16941207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology