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General NPI Number Information
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NPI Number | 1558357608
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Entity Type | Individual
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Provider Name | WILLIAM M LONG D.O.
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 7800 US 131 S SUITE C
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City | CADILLAC
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State | MI
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Zip | 49601-8437
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Country | US
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Telephone | 231-779-1167
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Fax | 231-779-1175
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Provider Business Mailing Address
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Address Line | 7800 US 131 S STE C
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City | CADILLAC
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State | MI
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Zip | 49601-7080
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Country | US
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Telephone | 231-779-1167
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Fax | 231-779-1175
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | WL006859
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 30958
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E4488
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 021740
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License Number State | GA
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