Basic Information
Provider Information
NPI: 1174706071
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LANGEVIN
FirstName: JEAN
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1095 PROFILE ROAD
Address2: ALPINE CLINIC - FRANCONIA
City: FRANCONIA
State: NH
PostalCode: 03580
CountryCode: US
TelephoneNumber: 6038238600
FaxNumber: 6038238688
Practice Location
Address1: 580 SAIN JOHNSBURY ROAD
Address2: ALPINE CLINIC - LITTLETON
City: LITTLETON
State: NH
PostalCode: 03561
CountryCode: US
TelephoneNumber: 6032597700
FaxNumber: 6032597679
Other Information
ProviderEnumerationDate: 12/13/2007
LastUpdateDate: 02/22/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X13593NHY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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