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General NPI Number Information
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NPI Number | 1144551540
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Entity Type | Organization
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Legal Business Name | DONALD P. LONG, M.D., P.A.
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Dates
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Enumeration Date | 01/25/2010
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 4640 9TH AVE STE 101
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City | PORT ARTHUR
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State | TX
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Zip | 77642-5820
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Country | US
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Telephone | 409-983-1066
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Fax | 409-983-7272
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Provider Business Mailing Address
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Address Line | 4640 9TH AVE STE 101
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City | PORT ARTHUR
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State | TX
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Zip | 77642-5820
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Country | US
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Telephone | 409-983-1066
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Fax | 409-983-7272
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DONALD PAUL LONG SR.
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Credential | M.D.
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Telephone | 409-983-1066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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