Healthcare Provider Details
I. General information
NPI: 1316903016
Provider Name (Legal Business Name): JAMES ARTHUR LONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/22/2006
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
70 MEDICAL CENTER CIR SUITE 307
FISHERSVILLE VA
22939-2273
US
IV. Provider business mailing address
PO BOX 388
FISHERSVILLE VA
22939-0388
US
V. Phone/Fax
- Phone: 540-245-7190
- Fax: 540-245-7191
- Phone: 540-245-7190
- Fax: 540-245-7191
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | 0101020610 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: