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NPI Code Detail

MEDICARE: REBEKAH R LONG M.D.

MEDICARE: REBEKAH R LONG M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician35078049OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396725644
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBEKAH R LONG M.D.
Provider Business Mailing Address
First Line : 424 WARDS CORNER RD STE 200
Second Line :
City : LOVELAND
State : OH
Zip : 45140-6966
Country : US
Telephone Number : 513-576-7700
Fax Number : 513-576-1020
Provider Business Practice Location Address
First Line : 4627 AICHOLTZ RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45244-1447
Country : US
Telephone Number : 513-753-2820
Fax Number : 513-753-2824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2006
Last Update Date : 09/10/2020

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Directions to “ REBEKAH R LONG M.D.” Practice Location

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