John Leslie Lange, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

N6768 Issued in AR

Practice address

5500 Ellsworth Rd.
Fort Smith, AR 72903-3222

Phone

(479) 242-2411

Fax

(479) 242-2412

NPI assigned

Mar 31, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1154382802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 402319",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303842319",
            "telephone_number": "479-709-7399",
            "fax_number": "479-709-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 ELLSWORTH RD.",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729033222",
            "telephone_number": "479-242-2411",
            "fax_number": "479-242-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "JOHN",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "AR",
            "license": "N6768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105907001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100134360A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "53049",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lane Richard Salazar PLLC
• John Lane
• John C Lane, M.D.
• Robert Cline Lane III, M.D.
• Lisa Laney, LMFT, LPC
• Kaneia Brianna Langel
• Pamela J Langston, RN
• Kathryn Lara, LPEI
• Vanessa Bato Laranjo, C.E.O
• G Keith Larkin, PHARM D

• Urology Physician in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Urology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.