Provider Demographics
NPI:1366418378
Name:LANGSTON, LLOYD GEORGE (MD)
Entity type:Individual
Prefix:
First Name:LLOYD
Middle Name:GEORGE
Last Name:LANGSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543-2835
Mailing Address - Country:US
Mailing Address - Phone:501-361-0606
Mailing Address - Fax:501-362-8842
Practice Address - Street 1:1715 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HEBER SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72543-2835
Practice Address - Country:US
Practice Address - Phone:501-361-0606
Practice Address - Fax:501-362-8842
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4115207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR102966001Medicaid
AR102966001Medicaid
53057Medicare ID - Type Unspecified