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NPI Code Detail

MEDICARE: DONALD P. LONG, M.D., P.A.

MEDICARE: DONALD P. LONG, M.D., P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144551540
Entity Type Code : Organization
Provider Name (Legal Business Name) : DONALD P. LONG, M.D., P.A.
Provider Business Mailing Address
First Line : 4640 9TH AVE STE 101
Second Line :
City : PORT ARTHUR
State : TX
Zip : 77642-5820
Country : US
Telephone Number : 409-983-1066
Fax Number : 409-983-7272
Provider Business Practice Location Address
First Line : 4640 9TH AVE STE 101
Second Line :
City : PORT ARTHUR
State : TX
Zip : 77642-5820
Country : US
Telephone Number : 409-983-1066
Fax Number : 409-983-7272
Authorized Official
Title or Position : PHYSICIAN
Name : DR. DONALD PAUL LONG SR.
Credential : M.D.
Telephone Number : 409-983-1066
Provider Enumeration Date : 01/25/2010
Last Update Date : 01/25/2010

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