Healthcare Provider Details

I. General information

NPI: 1730145756
Provider Name (Legal Business Name): D SCOTT LONG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DON SCOTT LONG MD

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 03/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 ANDERSON FERRY RD
CINCINNATI OH
45238-3325
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-7000
  • Fax: 513-246-5627
Mailing address:
  • Phone: 513-246-7000
  • Fax: 513-246-5627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number35-08-1814-L
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: