Provider Demographics
NPI:1992758726
Name:LANG, ROBERT J (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:LANG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 98978
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-8978
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:4500 W OAKEY BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-873-5110
Practice Address - Fax:702-873-8093
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ006470207Q00000X
IN02002157207Q00000X
NVDO2084207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200256280AMedicaid
NV1992758726Medicaid
IN410042917OtherRAIL ROAD MEDICARE
AZ675414Medicaid
AZ6740OtherAZ LICENSE
NVDO2084OtherSTATE LICENSE
IN02002157OtherSTATE LICENCE NUMBER
IN000000093781OtherANTHEM NUMBER
IN02002157OtherSTATE LICENCE NUMBER
IN000000093781OtherANTHEM NUMBER