Basic Information
| Provider Information | |||||||||
| NPI: | 1376623744 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LANGSTON | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 250 N SHADELAND AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462194959 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 620 NORTH MAIN | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726012926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8703652000 | ||||||||
| FaxNumber: | 8702626088 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 08/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | N-8357 | AR | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | N8357 | AR | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 02004363A | IN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 5J153 | 01 | AR BLUE CROSS | OTHER | 123972003 | 05 | AR | MEDICAID |