NPI 1154382802

John Leslie Lange, MD

Practitioner Urology Physician Fort Smith, AR

Practice location

Address: 5500 Ellsworth Rd., Fort Smith, AR 72903-3222
Phone: (479) 242-2411
Fax: (479) 242-2412
Mailing address: PO Box 402319, Atlanta, GA 30384-2319

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence N6768 (AR)

Other Urology providers in Arkansas →

Registry record

NPI: 1154382802
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Mar 2006
Record last updated: 22 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.