Individual
DEANNE LONG
Active
Individual
DEANNE LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4752590-1205
UT
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4752590-1205
UT
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
4752590-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10552
HEALTHY U
UT
01
—
243586
ALTIUS
UT
01
—
47525901202001
BC/BS
UT
01
—
608789600
W/C
UT
05
—
D3567
—
UT
01
—
P00396754
RAILROAD MEDICARE
UT
Enumeration date
03/17/2006
Last updated
04/15/2010
Update your record
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