Most Relevant Information
Provider Data
| NPI Number: | 1003686908 |
| Provider Name: | JACQUELINE LANGER |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 10004291A |
Most Important Dates
| Enumeration Date: | 01/03/2024 |
| Last Updated: | 10/04/2024 |
Provider Practice Location
7950 W JEFFERSON BLVD
FORT WAYNE
IN
468044140
Practice Location Phone/Fax
| Phone: | 2604357001 |
| Fax: |
Provider Mailing Location
5913 HALLOWELL PL
FORT WAYNE
IN
468156214
Provider Mailing Phone/Fax
| Phone: | 8152725409 |
| Fax: |