Healthcare Provider Details

I. General information

NPI: 1447189006
Provider Name (Legal Business Name): PATRICK M LONG MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 N EMERSON ST
DENVER CO
80218-3218
US

IV. Provider business mailing address

735 N EMERSON ST
DENVER CO
80218-3218
US

V. Phone/Fax

Practice location:
  • Phone: 248-343-9359
  • Fax:
Mailing address:
  • Phone: 248-343-9359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK MICHAEL LONG
Title or Position: MEMBER
Credential: MD
Phone: 212-203-1309