Provider Demographics
NPI:1174502546
Name:LANG, CHRISTOPHER M (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:M
Last Name:LANG
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 1:934 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-7135
Mailing Address - Country:US
Mailing Address - Phone:801-773-7060
Mailing Address - Fax:
Practice Address - Street 1:934 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-7135
Practice Address - Country:US
Practice Address - Phone:801-773-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT17286312052084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTE31832OtherRAILROAD MEDICARE
UT942938348OtherBLUECROSS
UT942938348LA3OtherEDUCATORS MUTUAL
UT20534OtherDESERET MUTUAL
UT107005631103OtherINTERMOUNTAIN HEALTH CARE
UT000069038Medicare PIN
UT107005631103OtherINTERMOUNTAIN HEALTH CARE
UTE31832OtherRAILROAD MEDICARE
UT20534OtherDESERET MUTUAL
UTE31832Medicare UPIN
UTU000075226Medicare PIN
UT942938348LA3OtherEDUCATORS MUTUAL
UT005763501Medicare PIN