Individual
FREDERICK R LONG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4579
(614) 722-4565
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-4579
(614) 722-4565
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35068458
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0235098
—
OH
Enumeration date
06/05/2006
Last updated
07/09/2007
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