Active NPI
David Langlois, PAC
- Physician Assistant
- Dalton, GA
National Provider Identifier
1265525141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001891
- Practice address
- 1104 Professional Blvd
Dalton, GA 30720-2588 - Phone
- (706) 226-5533
- Fax
- (706) 529-5858
- NPI assigned
- Oct 2, 2006
- Last updated
- Dec 19, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001891 | GA | Primary |
Addresses
Primary practice location
1104 Professional Blvd
Dalton, GA 30720-2588
Mailing address
1104 Professional Blvd
Dalton, GA 30720-2588
Phone (706) 226-5533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100000524B | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001891 | GA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229644800000",
"number": "1265525141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 PROFESSIONAL BLVD",
"city": "DALTON",
"state": "GA",
"postal_code": "307202588",
"telephone_number": "706-226-5533",
"fax_number": "706-529-5858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1104 PROFESSIONAL BLVD",
"city": "DALTON",
"state": "GA",
"postal_code": "307202588",
"telephone_number": "706-226-5533",
"fax_number": "706-529-5858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGLOIS",
"first_name": "DAVID",
"name_prefix": "Mr.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2008-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "001891",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100000524B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.